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Permit No. 0411 3C • APPLIGITION FOR A ',DING PERMIT AND A CERTIFICATE OF USE & '1UPANCY CITY OF CHINO HILLS le q//v/f7 _ . . . ,.. !�y^ ,4-i'ii1 i /oa44• /c). —6/ ADDRESS /�J p .73 Vis . ndP.) Pt. I CLEARED BY APPLICATION TYPE NO. C t7 LOT 63 BLOCK TRACT 1 3 6 5 1-2 0v D OWNER The Fieldstone Company THE FOLLOWING WORK IS AUTHORIZED BY THIS PERMIT. 0 ADDRESS 145 S. State College Blvd. , #660 ❑s1RUCE 0 PLUME. C MECH. ❑ELECT. m P.)yc cm' Brea ZIP 92621 PH. 990-3006 TYPE OF PROJECT iJ NEW G AUER 0 ADDITION ARCHITECT( LIG Na 0 REPAIR 0 CONVERT 0 DEMO ❑OCCUPANCY PMT, ENGINEER Hales-Langston . ADDRESS 3111 N. Tustin Ave. , #23 0 PROJECT LOCATION ON SIZE \\,.., DESCR,I�ION PROPERTY IN Stl FEET w CITY Orange nP 92665 �• 283-1770 iv&1-c-I- 54 ooNT ACTOR Same 'as Owner UCNQ 402826 '' y112i C6rojz . I 1 ,493 r ADDRESS Z't IJ o STOIC y' I I 1 ,356 V. CITY ZIP PH. 1 'IP-A1-c:;&:: I I 555 CITY BUSINESS LICENSE REMARKS I SPECIAL CONDITIONS I PROJECT DESCRIPTION LICENSE NO EXPIRATION M COTF La (N N 4- 6aLAL) A LICENSED CONTRARA CTOR'S DECLARATION /' \ I h:' m licensed under provisions of Chapter 9(commencing with Section 7000 of // e j -^_ �1T\�I Division 31;1 the :1!.'',5 i •.. • a Cods a and my license Is In lull forand sited. /� 4//f�y ��r- License du ''.f Dale Cordrador 6",.p tor— G(c9. ADDRFcq �.. /-s ..• CITY AND ZI° PHONE f F'ro CONSTRUCTION LENDING AGENCY iv ie••V" I herebyaffirm err _ to the performance of Ilse work for which L ^ ' this permit Is Issued(Sec.1097,Cir.C)Lenders Nims • J r��T"'� • • Lender's Address C`I AIL. OWNER-BUILDER DECLARATION •`7.yI��`� dig \'111 I hereby ,'• , • •I from the Contractor's License Law for the following reason: r ■ ` e _ _ cll....,of the property,o " - '; :.• with wages as their sole compensation,will do the work,and the structure Is not Intended or :'' • ,t .s. //� /) ❑I,as owner of the property,em exclusively contracting wit' '." •nlraclora to construct the a.. `-'r F`. / 1-7 a ❑I am eaempl under See .UPC lor Ihie reason - Deer INITIAL WORKERS'COMPENSATION DECLARATION iy� I hereby affirm Mel I have I certtllcele of consent to sell Insure, IssleI6 6171 raDWP Compensation Insurance,or a certified copy Ihe ol.POLICY NO 88 U OOMPANY Fireman' s Fund DATE EXPIRES: 5/1/9 3 o❑f Certified copy is hereby furnished CITY VERIFIER. ycs.Cer111ied copy Is tiled with the city GROUP DIVISION TYPE Dole• APPLICANT ' CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE VALUATION I cart' 1: ,,..f ,, , ••n ance of the work lor which this permit Is Issued,I shall not employ any person In any mann. I. t "• ti ed to the Workers'Compensation Laws of California, D"'' `'41"'' .„'.:. PERMIT FEES NOTICE TO APPLICANT II,after making this Certificate of Exemption, `I. iams subject to e Workers'Compensation provisions of Iha Labor Code,you must torlhwi '. .ith such ELECTRICAL: I STRUCTURAL:/6,2..th provision or this permil 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 ISSl1IWCE FEES: HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY 70 ENTER UPON THE ABOVE GEO REVIEW: I PIAN CHEM( MENTIONED PROPERTY FOR INSPECTION PURPOSES. ISSUANCE APPROVED: TOTAL PERMIT TEE: Signature of Applicard or Agent eats 2//c'/ -t-- /4z. DATE OF � I PERMIT NUMBER: Print Applicant's 4'a f Agent's Name ,( et/// 'CITY OF CHIN" HILLS __ .�l f1 DDDR SS /. `3 3 Vis& G-, 612, Dr. 7 ir:1,.1. BLOCK TRACT 13lv51_2 BUILDING INSPECTIONS RECORD LOT, pS��~.`j��:' . • OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 5.STATE WIlEOE-DLVD. PLACE ON THE JOB ADDRESS SUITE 660 BREkCAUIFORNIA-92811 CITY ZIP PH. / '-j/ I•,qq VS -SOD la PLUMBING DATE APPRROVIIIN EDNSSPPR'S • SIGNATURE GROUND SOIL P1 I 9/1r111-1 Q, GROUND WATER P2 /OA, I Gj t- / 1/�_ REMARKS /v TOP OUT P3 ! �/3 �-/- . SEWER P5 /0/1.2 (1 � (- � - - GAS TEST P6 ._5///7. .. e---//.. e--- r nP..� _ , < 1�‘-, -,,,_ q---121. 9 -2; /SE/Lv/UE /o/Zo I4P �, FINAL PLUMBING P12 I I MECHANICAL DATE APPROVED/INSPR'S • SIGNATURE UNDERGROUND/FLOOR MI I I ROUGH M2 I 7//v791 14 e- . AIR COND. M4 II FINAL MECHANICAL M12 I ELECTRICAL DATE APPROVEDIINSPR'S SIGNATURE TEMP.CONSTN.POWER E3 I I • UNDERGROUNDI I • PVC-METAL-D.B.C. El ROUGH WIRING I �f / /.3 / (//.3 I ' RECEPf.SPACING- SERVICE-CIRCUIT (/ SERVICE-CIRCUIT E2 • I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROVEDIINSPFt'S. SIGNATURE FOUNDATION:LOCATION REINFORCED 0 UFER ❑SI I 9/7r4/1- Q. SLAB:REINF,,.IJ MEMBRANE 0 S3 I /0/6/9-LI "� T F �-/A,e-IG tiyGE-= d SHF A w Z.-.4.7/1- Q. UNDERPINNING S4I I MASONRY S11 I I FIREPLACE SII I/dh.thv I aa _ROOF-FRAMI RV-F.SHEATHING S5 /3/2-z l�-p FRAMING S6 I O//'-//' 4 INSULATIONSOUND/ENERGY S7 I'21/1 /// /1�j I 4 LATH EXTERIOR S8 I?/(y/7 1 I G7( (l 7� - V LATH INIERIOR/GYPBOARD S9 /z /9.? I clr� ' M I II APPSIGNATU SPR'S DATE OF ISSUANCE PERMIT NUMBER ', �J SIGNATunE BUILDING FINAL 512 1 �� 7 1 ,...e...• - of b.i?L OL, CITY OF CHINO T1ILLS . ADDRESS /5c?.?3 Vida_2 6 nde, Dr. 10153 BLOCK TRACT 131v51_2 BUILDING INSPECTIONS RECORD OWNER/ THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 5.51/06 WJ1 3E-8LVD• PLACE ON THE JOB ADDRESS SUITE 660 1 CITY ZIP PH.7I4. 9Q D_5:010 PLUMBING DATE APPROVED/INSPR'S SIGNATURE GROUND SOIL P1 I VW1 Lh C/ GROUND WATER P2 I q it/ I 4 ei I REMARKS TOP OUT P3 . SEWER P5 I/0/1;2-..--- I /C7',......---- GAS TEST P6 I I I I FINAL PLUMBING P12 I I MECHANICAL DATE APPROVED/INSPR'S SIGNATURE UNDERGROUND/FLOOR MI I I ROUGH M2 I I AIR COND. 144 I • I I I FINAL MECHANICAL M12 I I ELECTRICAL DATE APPROVED/INSPR'S SIGNATURE TEMP.CONSTN.POWER 6.3 I I UNDERGROUNDI I PVC•METAL-D.B.C. El ROUGH WIRING RECEPT.SPACING- SERVICE-CIRCUIT E2 . 1 I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROVED/INSPR'S. CA // SIGNATURE FOUNDATION:LOCATION S1 I `/a � I REINFORCED ❑ UFER ❑ `'� ! ! ' SLAB:REINF. MEMBRANE 0 S3 I /140/6/' 2 Q UNDERPINNING Sr I I MASONRY S11 II FIREPLACE S71 I/O/� '/Q C// I ROOF FRAMING I ROOF SHEATHING S5 FRAMING S6 I I INSULATION I I SOUND/ENERGY Si LATH EXTERIOR S6 I I I LATH INTERIOR/GYPBOARD S9 I I I I I APPROVED/INSPR'S NSPR'S DATE OF ISSUANCE PERMIT NUMBER SIGNATURE BUILDING FINAL S12 I I `