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Permit No. 18710 �... BUILDING ADDRESS: 13773 VISTA GRANDE DRIVE PERMIT NUMBER: 1 18710 BUILDING INFORMATION APPLICANT INFORMATION ,g BUILDING PERMIT APPLICATION 44- Address: 113773 VISTA GRANDE DRIVE I Name: (WEST COAST CUSTOM ROOMS I Hh.. • _Mow, Community Development APN: 11024-103-06 Address: 1786 PINEFALLS AVE I ". 2001 Grand Avenue ,�v Lot: 146 City,Zip Code: (WALNUT,CA.91789 ._,F N:•-.= Chino Hills,CA 91709 Cross Streets: I I Phone/Pager: I(909)594-7547 I ext. 1 cmornnxonx.0 LICENSED CONTRACTOR DECLARATION Tract/Parcel: 113651-2 I City Bus Lic#: 1 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: 1$6,000.00 I ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect. OWNER INFORMATION Name: OWNER BUILDER DECLARATION STEPHEN WORCESTER Address: I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 13773 VISTA GRANDE DRIVE City,Zip Code: I,as the owner of the property,or my employees with wages as their whole City,Zip Code: CHINO HILLS,CA 91709 Phone: I ext. I 0 compensation,will do the work,and the structure is not intended or offered for sale. Phone: (909)590-8171 I ext. I Lic#: I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#: City Bus Lie#: construct the project. I Bus Exp: APPROVAL INFORMATION I am exempt under Section I I BPC for this reason WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: ILAURO BUGARIN I hereby affirm under penalty of perjury one of the following declarations: Contractor: WEST COAST CUSTOM ROOMS Date Issued: 18/7/01 Address: 1786 PINEFALLS AVE Finance Code: C4-SM I have and will maintain a certificate of consent to self-insure for workers'compensation ® as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code: (WALNUT,CA.91789 Census Code: which this permit is issued. Phone or Pager: 1(909)594-7547 1 ext. I I Final Date: 1 / c:25—/q�/ ��,, / Bus.Lic.#: 101-05750 I Final By: 1`43/O9 iii,-rSwl/ I have and will maintain workers'compensation,as required by Section 3700 of the 0 Labor Code,for the performance of the work for which this permit is issued. My Lie.#: 471619 I Extension: 1 Y workers'compensation insurance carrier and policy number are: : 4/30/02 I Reviewed By: ILAURO BUGARIN INSURANCE INFORMATION Lic.Clas : iB,HIC I Approved By: ILAURO BUGARIN Insurance Company: 'State Fund \ 1 1.0 PROJECT INFORMATION • Policy Number: 11620269 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: 11/1/02 Structure: ca Section need not be completed if permit is for one hundred dollars($100)or less Garage: 1 I 1 I I certify that in the performance of the work for which this permit is issued. I shall not employ Patio: 1 I I I any person in any manner so as to become subject to the Workers'Compensation Laws of Porch: 1 1 I I California and agree that if I should become subject to the workers'compensation provisions of Other: 1 DECK/PATIO 1 1REAR I 275 SF Section 3700 of the Labor Code. I shall comply with those provisions. DECK/PATIO 275 SF t a PROPOSED USE Date: lento I I Signature: , I certify I have read this application and state that the above information is correct. I a ee to comply with all City Ordinances and state laws and hereby authorize representatives o this City to COMMENTS enter upon the above mentioned property for inspection pu n oses. Date: 1$Ii I6 1 I Signature: 7f' " ,I . . i�J/ OTHER FEES REQUIRED ZONING SETBACKS GRADING PRIOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning: 1PD Front Yard: 20 Over X: I 0 i Issuance: 1 $29.00 1 Electrical: 1 $0.00 I Land Use: FR-1 Side Yard: Cut: 1 School: 1 N Permit Fees: I $189.38 I Plan: Rear Yard: 20 Fill: 0 Development: N Plan Check: I $63.18 I Plumbing: 1 $0.00 MS IP: $0.60 1 Occ: IR3 SSY: Total: 1 0 Sewer: I N Mechanical: 1 $0.00 I Structural: I $97.20 1 Type: IVN Water: I N Geo Review: I $0.00 1 Grading: I $0.00 1 Total Fee Due I $189.98 I / I-NSPECTION ����������N�^0��������N���� Permit Number Inspection Date Inspector Inspection Date Inspector Grading: Pregrade Meeting FINAL INSPECTIONS(Inspector verify following) Rough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL I Terraces County Environmental Sub Drains Health Dept Finish Grading Planning Dept Soils Certification Public Works Grading Certification Fire Rough Landscape As Built Approved Underground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG Building Sewer Final Grade U.G.Waste Plumbing Final Electric Water Service Storm Drain/Catch Basins Final Plumbing Final Mechanical U/GConduiVE|a�hoo| ' ' " ^ Compaction Report Fino| BuUding/ConutruoUon /0/2,174 `WA" ABOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION Water Meter Number Footings CERTIFICATE OF OCCUPANCY UFER Ground(Rebar/Copper) Hardware/Hold-Downs Piers/Caissons/Tendons OTHER: Slab Grade ` ~ ^ DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Ex& K__ Shear P ''''v ' � ~- — �r�� ^�4 ����r��' Roof Nailing 6K "/"��m' � o -4 / ��- . Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Drywall Interior/Exterior Lath Stucco Scratch Roof Covering Block Wall Inspections : Footing, ReBar 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal SWIMMING��OL� .' Location/Rebar/Bonding/Light Gr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Final Pool Temp Power Pole Electric Release Gas Tes