14133 (SFD)P.O. BOX 1504 No. 14133
Building 44--005 Cgzino .stanch LA QUIN 5 COAL ESTAD 92253
Address
Owner Century Hanes Communities
Mailing
BUILDING: TYPE CONST. VN OCC: GRP.- R3
Address 1535 South "D1 Street, Ste. 200 A.P. Number 604-3.$0-065
,City Zlp Tel.
Sin $ert�ar anc�, CA 92408(909) 3SJ-6007 Legal Description fat ?'bract 25290 Phase I
Contractor Project Description SFD Plan 2K
Same Rancho Ocotillo 4 La Minta Norte
At1►11P.CS
City
Zip
Tela
State Lic.
& Classif. $ 314473
City
Lic. # 2120
Sq. Ft. No. No. Dw.
Size 1905 Stories Units
-Arch., Engr., — Be21 aujin Aguilar & rASSOC.
Designer � �
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Mr sPassero Avenue
T 61,14) 359- 6065
Ri,versid6 CSA
Zlp 92505
Li�tn
)LICENSED CONTRACTOR'S DECLARATION
I hereby -affirm that -1 am licensed under provisions of Chapter 9 (commencigg with Section
7000) t. of Division 3 of the Business -and Professions`Code, and my license is In full force and
effec`'�,/�
SIGNATURE— ' !r / DATE
! CQ)YNER-BUILDER DECLARATION '
I hereby affirm that 1•ain exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness 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 role 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 or 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 -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 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.)
❑ I am exempt under Sec. B. 8 P.C. for this reason
Estimated Valuation $116,1,025.00
PERMIT AMOUNT
plan Chk. De p .
Plan Chk. BBI. 584.85
Const. 699 OQ
Mech. 55.50
Electrical 140.74
Plumbing 144.00
S.M.I..11.60
Grading 20.00
Driveway Enc. .00
Date Owner
Infrastructure 2,560.28
Arta in Purl -c Places 40.06
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. 0 Certified copy is hereby furnished.
TOTAL 4,256.03.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
REMARKS
(This section need not be completed if 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 person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
.NOTICE
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
I
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
i
Side Setback from Property Line
Lender's Name
FINAL DATE INSPECTOR
Issued by: Date/ Permit
j
Validated by: N
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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—
ate Mailing Address
Mailing
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE 2.
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
ETER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
0 TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN
SQ FT ®
WATER SYSTEM
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
—
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFING �/ d
r
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FINISH GRADING
j FINALINSPECTION
CERT. OCC.
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�ECTRICAL HEATING & AIR COND. SOLAR
r_
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 2.
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
ETER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
0 TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
cu. yd.
$ —Plus—x$—=$
LUMBER GR.
FRAMING
ROOFING �/ d
r
y
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREW L
MESH
INSULATION/SOUND
FINISH GRADING
j FINALINSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
MN
IVE
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This Certificate issued pursuant to the requirements of Section 306 of the Uniform Bullding�
Code certifying that at the 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 44-005 Camino Lavanda
Use Classification Single Family Dwelling Bldg. Permit No. 14133
Group R3 Type Construction • VN Fire Zone Use Zone SR
Owner of Building Century Homes Communities Address 1535 South "D" St., Ste. 200
City San Bernardino, CA 92408
By; Bruce Pelletier
�,:A �- ! _15-1-
Dote: February 6., 1995
Building Official
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