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Permit No. 0408 3C APPLICATION FOR • IILDING PERMIT AND A CERTIFICATE OF USE l CITY OF -CHINO HILLS A-pni r /(3,4-. /.0.3 -O/9 RES ADDS '3(JD � �/ / fJ, . CLEARED BY APPLICATION TYPE NO. F I, Lar 5GO BLOCK TRACT 13651-2 z a OWNER The Fieldstone Company THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT: a ADDRESS 145 S. State College Blvd. , #660 ❑STRUCT• ❑PLUMB. CMECH. 0ELECT. _ y CITY Brea ZIP 92621 M+• 990-3006 TYPE OF PROJECT LI NEW C ALTER 0 ADDITION ARCHITECTI LIC NQ 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PMT. ENGINEER Hales-Langston ADDRESS 3111 N. Tustin Ave. , #230 PROJECT LOCATION ON SIZE DESCR�I ION PROPERTY W SQ FEET ``` CITY Orange nP 92665 '"• 283-1770 f'"atre-1-, 54 VU I. �l STO(,V 1 ,493 �r mmmc�.m Same *as Owner uGNQ 402826 ADDRESS z a N° 57-04 V I I 1 ,356 ' CITY MP PH, S qFL 6' I I 555 CITY BUSINESS UCENSE REMARKS/SPECIAL CONDITIONS 1 PROJECT DESCRIPTION \\' LICENSE NO EXPIRATION DATE 1 ��� O / \ T UCENSED CONTRACTORS DECLARATION L�l N it (-RL rw a 6.4 s e I hehi.Jii.i., , licensed under provisions d Chapter 9(commencing with Section 7000 d _ d Division 9 thi Irl' ‘. a Code,and my lianas b In full lore and ailed, j A /e / ,J �/� ,�yf, •ori••,' f / yL� !�h'!/ V a/ UMW arse Tan F � Or, Contractor 'r' �,�,Q r -6 C. C[(<9. %. Cf�O 5[ CITY ITY AND AHD ZIP PHONE '�i' eCONSTRUCTION LENDING AGENCY � . I herebyaffirmere II iThAl1 . to Aha perlwmence d IM work for Which ' ,,,,t this permit Is Issued(Sec.1097,Civ.C)Lender's Name • J I Aga. Lender's Address • St AIL A OWNER•BUILDER DECLARATION v_~ ��QQ� I hereby ... . Irom the Contrador's Ucense Law for the following reason: Si"'mac 0 I,as owner of the property,o " ;,, .. with wages as(heir sole compensation,will do the work,and the structure Is not Intended or - •,. ie. rte_ 1.37 . 3 0 I nerd the properly,am exclusively contracting wit' '.1 .nuadors to construct the k\---)X.., 0 I am exempt under See. •BUPC for lhle reasonU Dale: INITIAI WORKERS'COMPENSATION DECLARATION }, I hereby affirm that I have a certilicete of consent to sell Insure, llgab X16 6 . 1 DWP Compensation Insurance,or a certified copy thereof,POLICY NO. COMPANY Fireman' s Fund DATE EXPIRES: 5/1/93 0 Certified copy is hereby furnished On'VERIFIEn• rig-Certified copy Is Iliad with the city GROUP DIVISION TYPE Dela• APPLICANT ' CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE VALUATION I cert' 'r', i .. n ince of the work tor which this permit Is Issued,I shall not employ any person In any manna 9. 1 I..� bed to Iha Worker,'Compensation Laws of Cafilornia, . Dais: •.-.... :1;01' . PERMIT FEES NOTICE TO APPLICANT II,eher making This Cenilicata of Exemption; ••I. •. oma subject al to IM Workers'Compensallon provision of Ow Labor Code,you must Ionhwi • •Ilh such ELECTRICAL: I STRUCfURAI; l Z 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 IS CORRECT.I AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS,AND MECHANICAL I ISSUANCE FEES: HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY 10 ENTER UPON THE ABOVE GEO REVIEW: I PLAN CHECK MENTIONED PROPERTY FOR INSPECTION PURPOSES. ISSUANCE APP7jQVE TOTAL PERMR FEE:EE Slgndn of uApplicant or Agent DateLL//.�l fff /6 (� 2 DATE OF 1S3UA /�' PERMIT NUMBER: Print Appl4arn'a I Agent's Name 9/4(.S''// CT/1 [// CITY OE .CHINO -HILLS al-r....„ BUILDING 1-..--...2.. e rn. .)' / -v lAsIzz. allnotzDr , . , ADDRESS ) LO :1, 1•6M'',‘'i''' BLOCK TRACT 136,51-2 BUILDING INSPECTIONS RECORD •,--,:a..45.,,,,,, . <,. OWNER THE FIELDSTONE COMPANY • POST IN CONSPICUOUS 145 5. 5 1Alt-COLLEGE-OLVD. PLACE ON THE JOB ADDRESS SUITE 680 SHEN-CALIFORNIA 92421 CITY ZIP PH.71171-qq1)-a9Dla PLUMBING DATE APPROVED4NSPRI • SIGNATURE GROUND SOIL P1 9 /tr/r1-1 4e-- GROUND WATER P2 /O6, I , TOP OUT P3 I lej ii 5 1 c:47C__.- I REMARKS . • • SEWER P5 1/b/1-1-/fitV 41 e---' . GAS TEST P6 -3 /11h-3 I i 'f -93 0.,-/ grt-trie.L-5- /0/-78 I , FINAL PLUMBING P12 I . . MECHANICAL DATE APPROVEDIINSPR.S SIGNATURE UNDERGROUND/FLOOR MI I I ROUGH )A2 Ii//(0 /4/') I ' . I1-' . • AIR COND. IA 4 I I . . I I FINAL MECHANICAL M12 I I . I • ELECTRICAL DATE APPRCNEDANSPR'S SIGNATURE TEMP.CONSTN.POWER E.3 I I . ey r ( (4-/-,---Zel-it-e47/. -- UNDERGROUND I . PVC-METAL-DEC El . . 22/' 3 ROUGH ROUGH WIRING L //6-/ I FIECEPT SPACING- SERVICE-CIRCUIT e--"-2.}---- E2 1 I FINAL ELECTRICAL EI2 I I STRUCTURAL DATE APPROVED/INSPR'S. SIGNATURE FOUNDATION:LOCATION UFER (!ii I 97/r/P2-1 z:4 ----- REINFORCED 0 • SLAB:REINF. 0 MEMBRANE 0 S3 UNDERPINNING S4 I I MASONRY SII I I FIREPLACE S11 I I . . ROOF FRAMING ROOF SHEATHING SS I 1//9Ard FRAMING 58 //14/ /4? . e"-- INSULATION SOUND/ENERGY Si J ,7.-/ /5.15 I fii), _ , • LATH EXTERIOR 58 I . /.Z Y/7-5 I g'q .2 . LATH INTEITIORIGYPBOARD S9 lo 7_/-v / 1 I . . P I . _ APPROVED/INSPR'S j SIGNATURE ; DATE OF ISSUANCE PERMIT NUMBER BUILDING FINAL SI? 1 or/1s ©� • crhs19-a ot4-62 CITY ,DL CHINO TTILLS BUILDING /3g1 3g1 i -- /,..�2 1., n yl/ ADDRESS U � V/C-f J((l(„C—ip/ ' Lot 56„, _ BLOCK TRACT /5/p51....2 BUILDING INSPECTIONS RECORD • OWNER TME FIELDSTONE COMPANY POST IN CONSPICUOUS 145 5.biaii COLLEGE-BlVD• PLACE ON THE JOB ADDRESS SUITE 660 . FORNIA��p����nA262 1 CITY ZIP PH.7/2/,'9q!\_2nfl/S/_ PLUMBING DATE APPROVEDANSPR'S f . '//� SIGNATURE GROUND SOIL P1 I q I/J yr l- --11''' / GROUND WATER P2 I i b/(j/�1 ' 't-- REMARKS TOP OUT P3 SEWER P5 17O/ 1'1...' I GAS TEST P6 I I • FINAL PLUMBING P12 I I MECHANICAL DATE APPROVEDANSPR'S SIGNATURE • UNDERGROUNDIFLOOR MI I I ROUGH M2 I I AIR COND. M! I I I I FINAL MECHANICAL M12 I I ELECTRICAL DATE APPROVEDANSPR'S SIGNATURE TEMP.CONSTN.POWER E3 I I - UNDERGROUND I I PVC-METAL-D.B.C. El • ROUGH WIRING RECUT.SPACING- SERVICE-CIRCUIT E2 . I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROVEDANSPR'S. SIGNATURE REINFORCED ❑LOCATION UFER ❑ 9/I /`i'L/`C Q 1- I /j ' SLAB:REINF. MEMBRANE 0 S3 I /0/6/11,1 4-0 • UNDERPINNING SI I I MASONRY S11 I FIREPLACE S11 1/e// /91.,1/ /9zi Q ROOF FRAMING I i ROOF SHEATHING S5 FRAMING S6 I • I INSULATION SOUND/ENERGY S7 LATH EXTERIOR S8 I I LATH INTERIORIGYPBOARD S9 II I I APPSIGNATURE NSPR'S DATE OF ISSUANCE PERMIT NUMBER SIGNATURE BUILDING FINAL $12 I I