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Permit No. 0413 3A/B APPLICATION FOR A r DING PERMIT AND A CC?TIFICATE OF USE & r" 'UPANCY CITY OF CHINO HILLS . �! yn-j(Q' VI -pC n1 r /e). "4/-/o .© --05 ADDRESS /3 v ) n Dr. CLEARED BY APPLICATION TYPE NO F. ID LOT 6/Ja BLOCK TRACT 13651-2 z n OWNER THE FOLLOWING WORK I5 AUTHORIZED BY THIS PERMIT• 0 The Fj�ldstone Company 0 ADDRESS 145 S. State College Blvd. , #660 n sTnuct 0 PLUMB.� C MECH. 0 ELECT. U, CI" Brea ZIP 92621 PH. 990-3006 TYPE OF PROJECT IINEW G ALTER 0 ADDITION ARCHITECT/ LIC NO. 0 REPAIR 0 CONVERT 0 DEMO 0 OCCUPANCY PUT. ENGINEER Hales-Langston ADDRESS 3111 N. Tustin Ave. , #230 PROJECT LOCATION ON IrEsa DESCRI ION PROPERTY FEET I �} CITY Orange aP 92665 P►+ 283-1770 1--c.f." 54 . CNifiAC1DR Same •a s Owner LIC Nn 402826 t. /Sl Srer y. I I 1 , 493 6111,4i • ADDRESS 2.CI N° 51-04v I I 1 , 147 6' CITY ZIP PH. a /4Ic..49e; E I I 555 c CITY BUSINESS LICENSE REMARKS I SPECIAL CONDITIONS I PROJECT DESCRIPTION 'J LICENSE NO EXPIRATION DATF w��` ���a A f .t) LICENSED CONTRACTOR'S DECLARATION C 1e'' I h, i''Im licensed under provisions of Chapter 9(commencing with Section J000 of /...,, r`\ Division 9 of Bte :'ll 1i._:,•r ;:i s Cods,and my licensect nse in furl torand erle . , / '�J Giw 41l/41/"3. 4 License Class IJcsn 'I,.. DEP, Contractor u:..• S..e (P L G91. ADDRESS ` Pro4' `[ CRY AND Zex PHONE ``' CONSTRUCTION LENDING AGENCY R. V I hereby affirm Thiel thele la a Id r,.r,.,:.c•,,,,. .4., for the performance d the work for whkh � n Q ' vi this permit is Issued(See 1097,Civ C)Lender)Name 'aiAC Lender's Address S/ y A s OWNER•BUILDER DECLARATION •4- 5 f CJCw e ••I hereby ' ; ,.. . •I from the Conuactor's License Law for the following reason: J •_ _ • 0 1,as owner of the property,a " - • • with wages as their sole compensation,will do the work,and the structure Is not Intended or •'4' "`•.4•, _te. i• /J; (J q---, e_s 0 I,es owner of the property,am exclusively contracting wit - •ntractora to construct the ��J�A °/ Wit• tt.a. 0 I am exempt under Sec. .B&PC For this reason Dale' INITIAL I WORKERS'COMPENSATION DECLARATION I hereby affirm that I have I certificate of consent to self Insure,or rlif cal J bar 7 1 Compensation Insurance,or a certified copy thereof.POLICY Nr • COMPANY Fireman's Fund DATE EXPIRES: 5/1/93 0 Grimed copy Is hereby furnished CITY VERIFIFn• ®.Cenlfled copy Is filed with the city GROUP DIVISION TYPE Dew. APPLICANT ' CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE VALUATION I can '1 i, ••n/ince of the work for which this permit is Issued,1 shall not empkry arty person In any mann 4.''I :. • bad Io the Workers'Compensation Laws of Calltornia. • Dew 'd' ✓'I''. PERMIT FEES NOTICE TO APPLICANT.II,alter making Ihis Cenllicale of Eaemphon, I'. • r• •:come subled to the Workers'Compensation provisions of the Labor Code,you must lorthw.I ' •r`.Ith such ELECTRICAL: I SIAUCTURAI/S`73 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 TO ENTER UPON THE ABOVE GEO REVIEW: I PLAN CHECK: MENTIONED PROPERTY FOR INSPECTION PURPOSES. ISSUANCE APPROVED: TOTAL PERMIT FEE: Signature of AppIInM at Agent Dale //,c. 7 PATE OF LANCE /4)�' I PERMIT NUMBER: Print Applicant's I Agent's Name ., ,S 4/l CITY OF CHINO -ILLS BUILDING - ADDRESS 4) J J rt / I Y7/a/1, d7! , _ , 1'gi.:elagirrr j,- BLOCK i '+�-`�- TRACT 3 ,��;.. -•-. - I lvSI-Z BUILDING INSPECTIONS RECORD OWNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145 5. STA PLACE ON THE J013 ADDRESS SUITE 660 3REA,-CALIFORNIA-92821 /� CITY ZIP "1/111.- H.7/I qq Win//�-�U'3 )Q , PLUMBING DATE APPROVEDIINSPR'S SIGNATURE GROUND SOIL P1 I 9/1%. I Q GROUND WATER P2 I /0-70. I 4a-C--- REMARKS `/ REMARKS TOP OUT P3 /d/r'S 4:::::1'--(. L( ` 5 y ' � �J p SEWER P5 I r0 -i cL '`____ i • GAS MST P6 I 3 /1//93 I V t V.P--e.._ ( l D iR (--141p,..."3-e- -- _l iii-,7) r,.�.►r e� s&-1'x I it/; 14 e 1 }� IFINAL PLUMBING P12 ! MECHANICAL DATE APPROVEDIINSPR'S SIGNATURE I UNDERGROUND/FLOOR MI I . Ir ... • ROUGH M2 I 7./////5 I 15V ; . . I . I AIR COND. AN I FINAL MECHANICAL M12 I I ELECTRICAL DATE APPROVEDIINSPR'S SIGNATURE TEMP.CONSTN.POWER E3 I I /i Al 1 e UNDERGROUNDI I 1 PVC-METAL-D.B.C. El ROUGH WIRING /i /i 5 I RECEPT.SPACING- -7j SERVICE-CIRCUIT E2 11 - I I FINAL ELECTRICAL E12 I I I STRUCTURAL DATE APPROVEDANSPR'S. 1 SIGNATURE FOUNDATION:LOCA ION SI I/04 /� REINFORCE UFER 0 /(Y\--1 SLAB:REINF. 0 MEMBRANE 0 S3 I /a/$/3 ZI ).9 UNDERPINNING S4 I I F MASONRY SII I I FIREPLACE SII I`Q`, I e...- . { ROOF FRAMING I ROOF SHEATHING S5 .-//0/51 �••• • FRAMING 66 I 7i�/1 /% /v'! 1^ ' INSULATION SOUND ENERGY Si I ZI2� / I 4� -- LATH EXTERIOR S6 I Z/'7- /?3 I -q -1 LATH INTERIOR/GYPBOARD S9 I Z,/ S/f'3 I I C. . .. APPROVEDANSPR'S . DATE OF ISSUANCE PERMIT NUMBER / SIGNATURE BUILDING FINAL SI2 I �///%/W I die - t COWe b__ ©44 CITY. OF CHINO Y'LLS . ..BDDRILDESG UIN /3'7 e1II�l-I. ( i/_� i d e. a AS U (F/ LOT (y-) . BLOCK TRACT I3fp5J-2 BUILDING INSPECTIONS RECORD OVNER THE FIELDSTONE COMPANY POST IN CONSPICUOUS 145:1.Siw E wttEGE"BLVD• PLACE ON THE JOB ADDRESS SUITE 660 1 Y CITY ZIP PH.7/1..9/1 U- t PLUMBING DATE // AP_/PRROVEDnNSPR'S . SIGNATURE© GROUND SOIL P1 I q/2r/2-LI d/)4__ GROUND WATER P2 I /6/6/11 I, I REMARKS TOP OUT P3 SEWER Ps I/0/ -1...-/ZZ I 4 GAS TEST PB I I • I I FINAL PLUMBING P12 I I MECHANICAL. DATE APPROVEDIINSPR'S SIGNATURE UNDERGROUNDTFLOOR Mt I I ROUGH 1.12 I I AIR COND. M{ I I I I FINAL MECHANICAL M12 I I ELECTRICAL DATE APPROVEDnNSPR'S • SIGNATURE TEMP.CONSTN.POWER E3 I I . UNDERGROUND . PVGMETAL•D.B.C. El I I ROUGH WIRING RECEPT.SPACING. SERVICE-CIRCUIT E2 I . I I FINAL ELECTRICAL E12 I I STRUCTURAL DATE APPROVED/INSPR'S. . SIGNATURE FOUNDATION:LOCATION /_ REINFORCED 0 UFER 0 S1 I 9/ //!/Fi e ' SLAB:REINF. 0 MEMBRANE 0 S3 I /O/E5 h SI G.e.-.- UNDERPINNING S4 I I MASONRY S11 I I FIREPLACE S71 I /8 !/)i1-- I ROOF FRAMING I I ROOF SHEATHING SB ' FRAMING S8 I I INSULATION I SOUND/ENERGY S7 LATH EXTERIOR S8 I I LATH INTERIORIGYPBOARD S9 I I I APPROJED/INSPR'S SIGNATURE DATE OF ISSUANCE PERMIT NUMBER BUILDING FINAL S12 I I