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Permit No. 0409 i:.L/ 1. APPLICATION FOR A 'LDING PERMIT AND A CERTIFICATE OF USE & -CUPAN CITY OF CHINO HILLS Q 1 i - �r /c4- /coa,o18 ADDRESS /38z17 I I nd Dr-. CLEAFIED BY APPLICATION TYPE NO. F ci LOT 55 BLOCK TRACT 13651-2 2 a OWNER The Fieldstone Company THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT A ADDRESS 145 S. State College Blvd. , #660 ❑STRUCT. 0 PLUMB. C MECH. 0 ELECT. m � c In an' Brea ZIP 92621 PH• 990-3006 TYPE OF PROJECT •L>7 NEW G ALTER 0 ADDITION ARCHITECT/ LIC NQ 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PMT. ENGINEER Hales—Langston ' ADDRESS 3111 N. Tustin Ave. , #230 PROJECT LOCATION ON SUE I `� DESCR�I ION / PROPERTY W SQ FF_ET QTY Orange ZIP 92665 P+• 283-1770 Vo -•C3 90 WNMACT.C3n Same as Owner . UC"Q 402826 I. Jz sFOI'V I I 1 . 355 �' ADDRESS z a""D ST,e v I I 1 ,240 an ZIP PH. l ti f f}{F I I 564 CITY BUSINESS LICENSE REMARKS I SPECIAL CONDITIONS I PROJECT DESCRIPTION LICENSE Nn EXPIRATION DATF \\\\\ UCENSED CONTRACTOR'S DECLARATION ZOL.1(N 1 `- � � 04 1 r '"` 1 ! I h:'•• r , m licensed under provisions of Chapter 9(commencing with Seaton 7000 of • , , _ . DfvWort 3 of the II. 't I ^,;., ,• s Code and my license b In lull lora and ellen. ��n� --7.6.:-. �i(/� de Lkense loss Llan r I"•• ���y`v / J —+/ Dau Contrsaor a(c1 CITY AND *+ •71 CITY AND ZIP I'NONF r. Pre I-yi' I CONSTRUCTION LENDING AGENCY gx-iew .,,1. I hereby affirm that there is.,1}:ii•.pri,.;.,., ,..t.u. for the performance of the work for Which ' this permit Is Issued(Sec.1097,Civ.C)Lender)Name 5 I Skit • • Lender's Address StP�A OWNERBUILDER DECLARAT I hereby " • r• ,. •1 from the Contractor's License Law Tor the following reason: S S f''"G 0 I,as owner of the property,o "' • ,. . with wages es their sole compensalton,will do the , n work.and the structure Is not Intended or °' "'•M le. . �- ❑I,asowner of the property,arri exclusively contracting wit` = .,.' •ntraclors to construe the (1Protect. 0 I am esompl under Sec. .UPC for this reason • I Date: INITIA' WORKERS'COMPENSATION DECLARATION I hereby atllrm that I have a certificate of consent to sell Insure.or a certlll a eI Wo rs' Compensation Insurance,or a coaled copy Blared.POLICY NO. DWP U 6 71 COMPANY Fireman's Fund DATE EXPIRES: 5/1/93 o Grllfisd copy Is hereby furnished TTY VERIFIED' C4.Cartllled copy Is Illed with the city GROUP DIVISION TYPE Dale: APPLICANT: ' . ' CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE VALUATION I cart'•'1... • .„,,,••q ante of the work for which this permit Is Issued,I shall not employ any person In any mann. • .1_'• bed Is mi Workers'Compensetlon Laws of Glllornia. Dale ''I PERMIT FEES NOTICE TO APPLICANT.II,offer making this CarlIticale of Esemplion, •'';'I. . .. erne subject to the Workers'Compensation provistona of the Labor Code,you must Iorthwr' ' .101 such ELECTRICAL: I STRUCTURAL /s '�J •�Y,'�..•.. provision or this permit shall be deemed revoked. PLUMBING: . I GRADING: I CERTIFY THAT I HAVE READ THIS APPLICATION ANO 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 TO ENTER UPON THE ABOVE GEO REVIEW: I PLAN CHECK MENTIONED PROPERTY FOR INSPECTION PURPOSES. ISSUANCE APP"RW.OVED: TOPERMIT FEE: ur Slgnse of Applicant Or AIWA Dale I`/`--•YI',12 /6-7- •—_ DATE OF ISSUANCE: PERMIT NUMBER: Print Appticanl'a I Agenl'a Hemi ,' 9 f/ —/ 2........._ . I O y©9 CITY OF CHINO-- HILLS .• ... -.._- • ... BUILDING ADDRESS 7 ViSla- 6-1' 2?)/0/e_. 1)r 0„..,...,......,,,„„.., BLOCK TRACT /3/p 5 7-2 BUILDING INSPECTIONS RECORD •,-5::- .,,,,31. • • OWNER THE FIELDSTONE COMPANY . POST IN CONSPICUOUS 145 S.s 1 Ai eCOLLEGE-SL-VD• PLACE ON THE JOB ADDRESS SUITE 660 OREN-CALIFORNIA-92021 CITY ZIP PH.7/4.-cie 1 o-a9c)e4, PLUMBING DATE APPRCNEDANSPR'S SIGNATURE GROUND SOIL Pi I 9/tril 7-J el 34-- GROUNDWATER P2 I /04 I -1.---- . . TOP OUT P3 I /0/*/'3 a<—K— _ REMARKS SEWER P5 I/(2(1 II/4 c7 <----- - A GAS TEST P6 I fil h 3 1 4:q' ' 1 SAT iv— 5"-e4.4--/ce I 71/9 I 4 e— FINAL PLUMBING P12 I ' I MECHANICAL DATE APPROVEDANSPFTS SIGNATURE UNDEFIGROUNDIFLOOR MI I I ROUGH M-2 1 2--//2--/ .1 I AIR COND. 114 I I I . . . FINAL MECHANICAL M12 I 1 ELECTRICAL DATE APPROVED/INSPRS r • • SIGNATURE TEMP.CONSTN.POWER E3 1 • .. • UNDERGROUND I . PVCMETAL-D.B.C. E1 I c--7Ac7 FA/eerZne*3 • , •.,4 c______ ROUGH WIRING RECEPT,SPACING- E2 I 2//7--//' I .../e.--- SERVICE•CIRCUIT : 1 I FINAL ELECTRICAL 512 I I II STRUCTURAL DATE APPROYED/INSPRS. SIGNATURE FOUNDATION:LOCATION REINFORCED 0 UFER OSI I q/SA-L-I "41, e- • : 4 SLAB:REINF. 0 MEMBRANE D s3 I /04;73-2.1 Z.4 e_____ UNDERPINNING S4 I- ' I MASONRY 511 I I FIREPLACE SII I id//3/11_,I e____ 1 . ROOF FRAMING ROOF SHEATHING S5 t/y/f-3 _ FRAMING 56 I 1.// /91 I c INSULATION SOUND/ENERGY Si I &//-;/1 I LATH EXTERIOR 58 I -/t v/9/ I LATH INTERIORrGyPBOARD S9 I 7/21/111 . 4 I I • I APPROvED/INSPITS SIGNATURE DATE OF ISSUANCE I PERMIT NUMBER BUILDING FINAL S12 I 03//7 I Gi e_ _ CITY OF €-HINO .TrTLLS BAg'grG /3 d L/ Vh 7 s . , ei ADDRESS I LOT 55 BLOCK TRACT 13/p51-2 BUILDING INSPECTIONS RECORD OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 S.SrmeCOL.EQE-BLVD. PLACE ON THE JOB ADDRESS SUITE 660 , CITY ZIP PH.DI/../]/T t�_2/)Vlo PLUMBING DATE I _/! AP%PRR TOVVEEDIIINN(SPPR'S . SIGNATURE • GROUND SOIL P1 I 7/t45./ti. I <717 GROUND WATER P2 I '1/Z,r I Q` ....-- • I REMARKS • TOP OUT P3 ' SEWER P5 I !O/7'1-, I c.Z GAS TEST P6 I I I I FINAL PLUMBING P12 I I MECHANICAL DATE APPROVEDIINSPR'S SIGNATURE UNDERGROUNDlFLOOR M1 I I ROUGH 1l2 I I AIR COND. A14I I I FINAL MECHANICAL M12 I ELECTRICAL DATE APPROVEDANSPR'S SIGNATURE TEMP.CONSTN.POWER E3 I I UNDERGROUND I PVC•METAL-D.B.C. El ROUGH WIRING I RECEPT.SPACNG- SERVICE-CIRCUIT E2 . 1 FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROVEDANSPR'S. SIGNATURE FOUNDATION:LOCATION 51 I /2 /c'1 /)4/(7------ • REINFORCED ❑ UFER ❑ r 1" /��T SLAB:REINF.,MEMBRANE ❑ S3 I /04,/1 Z I Q UNDERPINNING SII MASONRY S11 I I FIREPLACE Sit I/61/i)gzl ROOF FRAMING I ROOF SHEATHING S5 • FRAMING S6 II INSULATION I I SOUND/ENERGY ST LATH EXTERIOR S8 I I • LATH INTERIOR/GYPBOARD S9 I I 1 I I APP SIGNATURE NSPR'S DATE OF ISSUANCE PERMIT NUMBER SIGNATURE BUILDING FINAL S12 I I