14842 (SFD)P.O. BOX 1504
Building
ss 45-055' Ra levfod Ct. LA Q
Address UINTA, CALIFORNIA 92253
Addr
Owner Inco Homes
BUILDING: TYPE CONST. : IM OCC: GRP. -R3
A.P. Number
Legal Description Lot 1.5 Tract 23995~1
Project Description Plan 4
. Yid® n.;i,t+%Jfd .at' La � ,)dilSsnta -
No. 14842
Mailing
Address 250 E. Rincon Ste. 262
City Zip Tel.
Corona,, CA 91719 (90-9)736-0700
Contractor
" Sa�18
State Lic. City
& Classif.. S 523968 Lic. # 3318
Arch., Engr., �-
Designer C.
11jeslast De La Guerra 665)9652-4575
CityZip State
Santa - Barbara, CA 9x101 Lic. # 01285
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
*7/000) of Division 3 off-thee.Business and Professions Code, and:my license is in full force and
"€effect �,!.✓ f 1'%3
SIGNATURE DATE
OWNER -BUILDER DECLARATION
Thereby affirm that I am exempt from the Contractors License Law for the. following
reason:..(Sec. 7031.5,Business and .Prolessions Code: Any city or county. which. requires .a .
permit to construct, alter, improve, demobsh, or repair any structure, prior to its issuance *also
requires the applicant for such permit to We a signed, statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the. alleged exemption. Any violation of Section 7031.5 by 'any .applicant for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
❑ I,.as owner of the property, or.my employees with wages as their sole compensation, will
do thework, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The ,Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his 'own employees,
provided that such Improvements are not Intended or offered for sale. If, 'however, •thebuilding
orimprovement is sold within one year of completion, the owner -builder will have -the burden
of proving that he did not build or Improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property* who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec: B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent. to self -insure, or a certificate of
Workers_Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poll�crCy , o. Company
� opy is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed N the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
' employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ff, after, me". this Certificate of. Exemption you should become
subject to the Woikers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATIONCOVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES --UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days..
1 certify that I have read this application•and state that the above information is correct.;
I agree to. comply with all city and.county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. 2008
Size
No. No. Dw.
Stories - . Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$120v912.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
594.65-
94.65Const.
Const.
713,06-
Mech.
55.50"
,Electrical
145 a 90.
Plumbing
138.10
S.M.I. 1
12.05"' .
Grading
20.00
Driveway Enc.
00
Infrastructure
2,720.52
Arts in -Public Places 52.219
TOTAL
4.451.94
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front. Setback.from Center Line
Rear Setback from Rear Prop. "I
Side Street Setback from Ce r ine
Side -Setback from Prope. I
FINAL DATE INSP. T R
Issued by: Date �y • Permit I
Validated by: '41
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW F ES
1ST FL. SO. FT. ® $
UNITS
e
2ND FL. S0. FT.
COLL, AREA
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
HEATING (ROUGH)
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
QT
DRAINAGE PIPING
WALL SO. FT.
DUCT WORK
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
METER LOOP
WATER PIPING
NOTE: Not to be used as property tax valuation
OTHER APPJEOUIP.
FLOOR DRAIN
MECHANICAL FEES
GAS (FINAL)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GROUT
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
ROOFING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
REMARKS:
SO.FT.GAR ® 3/4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLU
UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE
ROUGH PLUMB.
1.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER ORS
QT
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
_
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$-=$
LUMBER GR.
FINAL INSP.
FRAMING /
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING DV
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION LOW P
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
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This Certificate issued pursuant to the requirements of Section 306 of, the Uniform Bull -ding
Code -certifying thidtaft'h6-time of issuance this structure was in compliance with,the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 45-055 namblewood Ct.
Use CIO . ssification Single' Fardl�7 Dviellinq Bldg. Permit No. ].484 .
Group R Type Construction VT --T —Fire Zone Use Zone R2
Owner of Building Inco Homes Address 250 E. Rincon,Ste. 202
city Corona, Ca., 91719
BY; Bruce Pelletier
Date June 28, 1905
Building official
POST IN A CONSVICUOUS PLACE
I
77
PlT
UF Tgh_&��
Ct�t
a Qutnta
It t M9I dn'b �Safet �t to
This Certificate issued pursuant to the requirements of Section 306 of, the Uniform Bull -ding
Code -certifying thidtaft'h6-time of issuance this structure was in compliance with,the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 45-055 namblewood Ct.
Use CIO . ssification Single' Fardl�7 Dviellinq Bldg. Permit No. ].484 .
Group R Type Construction VT --T —Fire Zone Use Zone R2
Owner of Building Inco Homes Address 250 E. Rincon,Ste. 202
city Corona, Ca., 91719
BY; Bruce Pelletier
Date June 28, 1905
Building official
POST IN A CONSVICUOUS PLACE