14137 (SFD)Building
Address
Owner
r
c
P.O. BOX 1504
44-360 Camino • Azul 78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Century Homes Ccrimni.ties
Mailing 1535 South *D* Sheet, Ste. 200
City Zip Tel.
Sen Sernardincg CA 92408 1(909)381-6007
Contractor
Same
Address
City
Zip Tel.
State Lic. B 324473(City 2120
& Classif. Lic. #
—-Engr.;
Designer Bdii i_n. Aguilar & Assoc.
Designer ] g
SAmdar.`eisspassero Avenue Thi 14! 359-6066
City -•�"'" Zip> State
.Wr�Y31$E:r� C 92505 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provision o Chapter -9 (commencing4ith Section
7000) of Dlvisiionn 3 of the Business and Professions Code --and my license is in full forc464nd
effectr
_SIGNATURE
r OWNER-BUILDER'DECLARATION r
I hereby affirm that I am exempt from the contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile 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 Five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, 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, the building
or improvement is sold within one year of completion, the owner -budder will have the burden
of proving that he did not build or mrprove for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to corn
strucl 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 contractors) 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
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner t
NOTICE TO APPLICANT. It, after making this Certificate of Fxemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
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.
I 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
No. 14137
11LDING:' TYPE CONST. VN OCC: GRP.
P. Number 604-492-004
M
egal Description Lot 39 Tract 24527
roject Description SFS Plan 2B
Rancho -Ocotillo @ La Quinta Norte
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line '
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Dare-_ Permit
Validated by:
Validation: C--
Sq. Ft.
Size . 1905
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
X25.00
S116025.00
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
334.85
Const.
639.00
Mech.
55.50
Electrical
140.74
Plumbing
144.00
S.M.I.
11.60
Grading
20.00
Driveway Enc.
.00
Infrastructure
2,560.28
Arts in PublIc
Places
40.€ b
TOTAL
41,256.11013
4,006.03/
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line '
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Dare-_ Permit
Validated by:
Validation: C--
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE dROUGH
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCTWORK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (ROUGH) METER LOOP
DRAINAGE PIPING
CAR P. SQ. FT. ®
REINF. STEEL
WALL SQ. FT. ®
DRINKING FOUNTAIN
SO FT ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
BOND BEAM
FLOOR DRAIN
MECHANICAL FEES
$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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 A ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE dROUGH
PLUMB. I
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATE SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$ =$
LUMBER GR. FINAL INSP. !
FRAMING 'I �$ FINAL INSP.
ROOFING '
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
GRADING
FINAL INSPECTION
CERT. OCC.
ccniro MMAi
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REMARKS:
NSPECTOR'S SIGNATURESI ITIALS
GARDEN WALL FINAL ) A -,A . -7wi -7wj7