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Permit No. 0406 3A/B - APPLICATION FOR A LING PERMIT AND,A CERTIFICATE OF USE & T 'PA • . . CITY OF CHINO HILLS . . , 14,ou r /04 -it), -.01 . .... BUILDING /3YL/S) Yigta. eamdDr. 1 C.LEAJIE0 BY APPLICATION TYPE NO c F C, LOT OF BLOCK TRACI 13651-2 G7 3. THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT: o OWNER The Fieldstone Company c." 33 ADDRESS 145 S. State College Blvd. , #660 0 STRUCT, 0 PLUMB. 0 MECH. 0 ELECT. m tn P? an' Brea ZIP 92621 PH. 990-3006 TYPE OF PROJECT It NEW G ALTER 0 ADDITION ARCHITECTS , LIC NO. 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY P1.41; ENGINEER aleS-Langston 01/4 ,Ns. ADDnEsS 3111 N. Tustin Ave. , #230 PROJECT LOCATIONON I irSO.FEET DEscnnioN i Dry Orange ZIP 92665 N. 283-1770 / k-c-1.1 . =micron Same 'as Owner UCNG 402826 1 1 f?.J.: 61--e, v. I I 1 ,493 • ADDRESS 2-al" 5To4 V I I 1,147 ' CITY ZIP PH. P-ilr;;6 I I 555 'N .,..., CITY BUSINESS UCENSE REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION LICENSE NO EXPIRATION DATF LICENSED CONTRACTOR'S DECLARATION Lg.,'Nil 4— C-,.4.4).41-4.9- d 1øa._.S t.\\ • I h,' ; i 1, , licensed under provisions of Chapter 9(commencing with Section 7000 of ffA, ometen 301 the ill ''.r.I . • •, • I Code,and my license Es In luIt force and Idled. ./J4e.....-4 .1.''".*/#•••'.-2,d a21.--e . .. ..,,, , „ • License Orr. Ucan '1-• DEP, Contractor •-• S---e 4.cl c- c k 9. ADDRESP - CITY AND ZIP PHONE Pt-rea I CONSTRUCTION LENDING AGENCY ge se.Cr•• I hereby affirm 1141 there Is ti ben-1441:+Y,,, ,4i, 101 the performance of the work for which this permit Is Issued(Sec.1097,Civ.C)Lender's Name • 5 1.0-R . . Lender's Address • 5/frial- OWNER•BUILDER DECLARATION r+.. .6 5 I CLQ * I hereby• '' '•1'• I ,.,.: .1 from the Conirecior's license Law for the following reason: . —.. k _ 7 0 I,as owner of the property,o '' • .. with wage.as their sole compensation,will do the - . work,and the structure Is not Intended or r' ' *.,•,..,,le. de46f/tf ,Lii ,i4-r-•t. e-Ci 2 Er'3 • O I,as owner of the property,am exclusively contracting Wit' ',.,' .ntractors to construct the Mist'''. 11 0 I am exempt under Sec. .BILPC for this reason "-• • .„, Darr INITIAL WORKERSCOMPENSATION DECLARATION I hereby affirm that I have a certIllcale of consent to self insure,or a cenifIcale of Wotkers' Compensalion Insurance,or a certified copy thereof.POLICY NO DWP80566171 =Amy Fireman's Fund DATE EXPIRES: 5/1/9.3 o Certified copy Is hereby furnished CITY VERIFIr• Id-Candied copy Is filed with the city GROUP DIVISION TYPE Dale' APPLICANT ' . . CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE VALUATION I cert' ' I. , .• •yr Inca of the work f or which this permit Is Issued,I shall not employ any person In any mann t 1 %1,.,,,. .. lied to the Workers'Compensalion Laws of California. our •l'i:II' ,..,. , PERMIT FEES NOTICE TO APPLICANT II,after making this Cenllicate of Exempiron, .I 1 • ,. .. oma subject ELECTRICAL: I smucrunAL 15--7 3 to the Workers'Conmensailon provisions of the Labor Cods,you must forthwi ." . .1th such provision or this permit shall be deemed revoked. -....,, ,, PLUMBING: . I GRADING: I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION MECHANICAL I ISSUANCE FEES: IS CORRECT I AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS,AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE . CEO REVIEW: I PLAN CHECK: MENTIONED PROPERTY FOR INSPECTION PURPOSES. ISSUANCE APPROVED: TOTAL PERMIT FEE: signiture el Applicant Or NMI Delo '-e- 45-73 GATE OF ISSUANCE _. PERMIT NUMBER: Print Applicant's I Agent's Name • 97/S72j-L_-- 0 gt7 • CITY 'OF') CHINO _._.ILLS ,1A ...•C VA' ADDRESS� 3!S Li V I J�� //.a hr..,V . ,.. 0 BLOCK TRACT l3/p5/ 2 BUILDING INSPECTIONS RECORD • OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 U. MAIC Viii-LEGE-BLVD. PLACE ON THE JOB ADDRESS SUITE 660 OREN-CALIFORNIA--9262' /�fl 30Dto •CITY ZIP PH,7'11..CM o..3LJV W PLUMBING DATE /! APP`R7OVEDIINSPR'S SIGNATURE GROUND SOIL PI I g/Zs'/s i- 4 v GROUND WATER P2 I f D/6./1 1OP OUT P3 /Q '}' / IA �""�� REMARKS SEWER P5 /ro/-V-Lh'�"" ' C-1-(------ �1 / . � � GAS TEST P6 -Z, ////C' e— i ���.Ti� � l���/`?Cr`. f / —/6-6,4/10E- /01,-6- .,,pe____ -�— FINAL PLUMBING P12 I MECHANICAL DATE AFPROVEDANSPR'S , SIGNATURE UNDERGROUNDTFLOOR MI I I ROUGH M2 11L/r.Pi) I '-e-' AIR COND. MI I I FINAL MECHANICAL IA12 I I ^/ /J ELECTRICAL DATE APPROVEDANSPR'S • e....-_--,r �����,✓SNP�2 c`' �/� ��`- SIGNATURE //,,/,�mss_ TEMP.CONSTN.POWER 53 1 I UNDERGROUND PVC•METAL•D.B.C. El I I • 1 RECEPT.SPACING.ROUGH WIRING 21I 1 r ' SERVICE-CIRCUIT E2 r �� FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROJED1INSPR'S. SIGNATURE FOUNDATION:LOCATION SI I fi� /�n I [//} P REINFORCED 0 UFER 0 / C. �`y - SLAB:REINF MEMBRANE ❑ S3 1/011?/4'1......-I Q�/`� UNDERPINNING SI I ' I MASONRY SII I I FIREPLACE SII Ver//3/14`(_____-- ROOF FRAMING 1 ROOF SHEATHING SS Izl Z r/0t i < Le—FRAMING S86113 cie_. INSULTION SOUND/ENERGY 1 J - i 3 izi'7_ — SUUNDlENERGY Si 7/�lS��f' -, LATH EXTERIOR SB 7/-2' •C! !4S ../< LATH INTERIORIGYPBOAFID Sc `7-/-7-7/is I ��]O ' I[ APPSIGNAT NSFR'S DATE OF ISSUANCE PERMIT NUMBER L. //� / I . 1SIGNATURE I BUILDING FINAL S12 I V/i y//Q� �y _ 9/I�7g 2� OD�k3 CITY -OF- CHINO I___-,LLS •- BUILDING 13 ' g 1/I e���M'^ n �. ADDRESS L� V �,/a r( � ' LOT 5Sry . BLOCK TRACT 13/p51-2 BUILDING INSPECTIONS RECORD CANNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 5.51ATE GuL;EGE BLVD. PLACE ON THE JOB ADDRESS SUITE 660 CITY ZIP PH.7/1- /)U'3001P ' PLUMBING DATE `APPPRROVEDIINiSPPR'S ' . — SIGNATTURE GROUND SOIL P1 I 9,2-1 f !7/ I q-e✓ GROUND WATER P2 I /ok,/92I 4e_____ . TOP OUT P3 I REMARKS SEWER PS I l 0/22.../ I '7 e. ....- GAS GAS TEST P6 I I I • • FINAL PLUMBING P12 I I I I I MECHANICAL DATE APPROVEDnINSPR'S SIGNATURE UNDERGROUNDIFLOOR MI I I ROUGH 142 I I AIR COND. ►N I i I I i FINAL MECHANICAL 1412 I I ELECTRICAL DATE APPROIEDANSPR'S 1 SIGNATURE .. TEMP.CONSTN.POWER E3 I I UNDERGROUNDI I . PVC-METAL-D.B.C. El • ROUGH WIRING RECEPT.SPACING- SERVICE-CIRCUIT E2 I . I I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROIIED1INSPR'S. SIGNATURE FOUNDATION:LOCATION f/n/ REINFORCED 0 UFER OSI I 7/Zs L 7`'1_- Z� ' SLAB:REINF. 0 MEMBRANE 0 S3 I /0/6/i/-1 UNDERPINNING $4 I r I MASONRY S11 I I FIREPLACE Sit I/0//3 ii e ROOF FRAMING I I ROOF SHEATHING S5 • FRAMING S6 I I INSULATION SOUND/ENERGY S7 LATH EXTERIOR SB I I LATH INTERIOR/GYPBOARD S5 I I I I APPSIGNATURE INSPR'S DATE OF ISSUANCE PERMIT NUMBER SIGNATURE BUILDING FINAL SIT I I