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Permit No. 0410 1B/c APPLICATION FOR A WING PERMIT_ AND .',.CERTIFICATE OF USE & :UP• •r'` CITY OF CHINO HILLS /4-"Ajr /Daq./0,3-0/7 BUILDING /3835 1/ 5,fyl & Dr. CLEARED BY APPLICATION TYPE NO. C ADDRESS ��;J yJ Q (�(�6t a P g LOT 54 BLOCK TRACT 13651-2 z a OwNEn The Fieldstone Company THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT: a ADDRESS 145 S. State College Blvd. , #660 0 SYnuCT. 0 PLUMB. C MECH. 0 ELtCr. y Y., yc CITY Brea ZIP 92621 'H. 990-3006 TYPE OF PROJECT t NEW G 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 DESCAIpj10N ` PROPERT7 I IN SQ FEET CITY Orange ZIP 92665 PH. 283-1770 Kop-c.158 k\...$ coNTR Same as Owner ucNQ 402826I. I --5r 51-6A I I 1 ,114 ',t ADDRESS 2.d ls1o STOPS I I 1,246 CITY ZIP PH. 1 (/}P_ 1- E I I 619 •\%\s,a CITY BUSINESS UCENSE REMARKS/SPECIAL CONDITIONS/PROJECT DESCRIPTION LICENSE NC EXPIRATION CAFFr w,_ `` UCENSED CONTRACTOR'S DECLARATION t N h 4. C Q.4 4, fL .4.s r h:'.I' ,. ..,, : m licensed under provisions of Chapter 9(commencing wIlh Section 7000 of V Division s d lbe al- '�r •_.. :.r • Code.and my license la In full force and*Bea ` '!�,w'�!'�� �/�7cP0..t.._.. License Oat Ann t,.. Oaf. r CoMndor -a• `,.,, ADORFCe „ 1� //--+� CITY AND ZIP PHONE ` "et f t-o•51- \\ CONSTRUCTION LENDING AGENCY I hereby alOrm Ihd Thera II,i!'whu rtr:.41.' C c for the performance of IM work for WWII L ' this permit Is Issued(Sec.1097,Civ.C)Lodge'Nam a Lender's Address S. Q OVNER•BUILDER DECLARATION ` O�'� �r�,p- I hereby: " .r ,• . •1 from the Contractor's license Law for the following reason: " 5 f ` ' p rty .� 0 I,v owner d the properly o with wages as Ihelr sole r Ompenselioq will do the \ work,and the structure Is not Intended or '' ' •, is. �/J� A n n A 0 I,as owner of the property,am exclusively contracting wit l ;,rr •ntractors to construct the K �/`�� _ r���/ Pre-• +: , 0 I am exempt under Sec. .B&PC For Ills reason Dale: INITIAI WORKERS'COMPENSATION DECLARATION } I hereby affirm Thal I have■certpicale of consent to sell insure,or e g 6%1,7. % 71 Compensation Insurance,or a certified copy thereof.POLICY NO. COMPANY Fireman' s Fund DATE EXPIRES: 5/1/93 0 Certified copy Is hereby furnished CITY VERIFIER. Fig-Certified copy Is Flied with the city GROUP DIVISION TYPE Del., APPLICANT • CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE VALUATION I cert". • •rr and of the work for which this permit Is Issued,I shall not employ any person In any mann ••`'I.r•; ,r;1, bloat to the Workers0 'Compensation Laws of California. . Dew • ''I PERMIT FEES NOTICE TO APPLICANT II,after making this Centfical.of Exemption , I. `,r• •: ems subject ELECTRICAL: I SrnUCTURAL: /41/41612.to hPensanon rovlsbna of ifs labor Code,you muel lonhwl .11 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 IS CORRECT,I AGREE 10 COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS,AND MECHANICAL I ISSUANCE FEES: HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE CEO REVIEW PLAN CHECK: MENTIONED PROPERTY FOR INSPECTION PURPOSES. ISSUANCE APPROVED:) TOTAL P,/ERMIT FEE: elPP Signature Applicant or Agent Data - ( ce y(/P / I � DATE OF t SS� /GPERMIT NUMBER: Prim Applicant's'a IAgenla Name //7S /".' Oy/ CITY OF CHINC ,HILLS - . ' f • BUILDING � 1 An /�] �/� 1 ADDRESS: / .3 ll I r c UL, 6�L? lL'L - LW• � LO ,7 ci ;, BLOCK TRACT 131051.-.21 BUILDING INSPECTIONS RECORD • OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 0.aihi C COLLEGE-BLVD. PLACE ON THE JOB ADDRESS SUITE 660 BRED-CALIFARNIA-9262'- CITY ZIP PH.7/i/.-9'7 U2�-�Uto PLUMBING DATE / // APPPRROVEDIINSPR'S ' . SIGNATURE GROUND SOIL P1 q /z i4z_I GROUND WATER P2 `O/(p I a"-- -- TOP OUT P3 /O/I 1 I /�7.�Q__ REMARKS SEWER PS I /O/ZI � 4/:7.-e�� e, 1\`- [� GAS TEST PB I S//i/'3 I 1 //'-•l: ``X_ 1- (ii- i >� -/ /f,,C •. r„r) 5 r://-04'-6 I Ib/Z.s �I-' / / FINAL PLUMBING P12 I I • MECHANICAL. DATE APPROVED/INSPR'S SIGNATURE UNDERGROUND/FLOOR M1 I , ROUGH M2 I -Z--//l'/4-3 • AIR COND. M4 II I I - FINAL MECHANICAL M12 I I • ELECTRICAL DATE APPRCNED/INSPR'S SIGNATURE TEMP.CONSTN.POWER E3 IUNDERGROUND • / /l PVC-META.D.B.C. El I • 6--, !�/�-xoGs- - s .6-7/64,1--- . (7 E f/- ROUGH WIRING I //�/�3I ROUGH SPACING- // 4,4t-/e/?-66- ��� E ��e-4�- O(� SERVICE-CIRCUIT E2 FINAL ELECTRICAL 512 I I I STRUCTURAL DATE APPROVEDANSPR'S. /SI ) ��y/ SIGNATURE FOUNDATION:REINFORCED LOCATION❑ UFER 0 I g1 2t/9z I LJ�/ SLAB:REINF. 0 MEMBRANE 0 S3 I ! 7` '/1 AI C/r_ j UNDERPINNING S, I I MASONRY S11 I I . FIREPLACE S11 /o//3191,-I Q e--- ROOF FRAMINGI ROOF SHEATHING S5 0,./W9.3 ,/ 1/97 •4= 7l t--",_____-- FRAMING S6 I T // ^ G/J -'7 I i- INSULATION SOUND/ENERGY ST 2-‘441/: 3 I 4:? LATH EXTERIOR SB 7/z v/1e_. 2/�1�n - , LATIIINTERIORlGYPBOARD S9 , I a • I I APP SIGNATURE 'S DATE OF ISSUANCE PERMIT NUMBER / SIGNATURE BUILDING FINAL SI2 I �//7/7 I G7.e : CV(1f92__ O 1'0 CITY OF CHINO VILLS --* • AoDREs /3835 Vigixe- - £>r. LOT 54 . BLOCK TRACT 131p51-2 BUILDING INSPECTIONS RECORD OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 S.51A1t BLVD. PLACE ON THE JOB ADDRESS SUITE 660 CITY ZIP PH.7/2/-CM Vtl_2L^30C)/_y . PLUMBING DATE APPROVEDANSPR'S l ' SIGNATURE ! GROUND SOIL PI I /!/J//iA .4e GROUND WATER P2 I 16/r I �..e.- -- } I I REMARKS I TOP OUT P3 I SEWER PS I /o(2j1/ I 4 (--- 1 GAS TEST P6 I I I • I FINAL PLUMBING P12 I I I MECHANICAL DATE APPROVEDANSPR'S i SIGNATURE 4 UNDERGROUNDIFLOOR M1 I I ROUGH M2 AIR COND. M! II I I FINAL MECHANICAL. M12 I I ELECTRICAL DATE APPROVEDANSPR'S SIGNATURE TEMP.CONSTN.POWER E3 I I UNDERGROUNDI I PVC•METAL•D.B.C. El ROUGH WIRING I I RECEPT.SPACING. SERVICE-CIRCUIT E2 • I I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROVEDANSPR'S. SIGNATURE UNDATION:L ON S1 I ?4 CA 41r I 4 REIN ❑ UFER ❑ / SLAB:REINF. MEMBRANE 0 S3 I /0760/"/Z,I e...--.7 UNDERPINNING S/ I I MASONRY S11 II 1 FIREPLACE S11 I///3/ -2-I' "- ROOF FRAMING I ROOF SHEATHING S5 • FRAMING S6 I I INSULATION SOUND/ENERGY S7 I I I LATH EXTERIOR S6 I I LATH INTERIORIGYPBOARD S9 I I II SIGNATUREAPPNSPR'S DATE OF ISSUANCE PERMIT NUMBER BUILDING FINAL St2 I I