14069 (SFD)T4 -tit 4 4 Q"
Buildin
Address 44-120 Camino Lavanda
Owner Century Homes Comunities
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 1535 South *D" Street, Ste. 200
City Zip Tel.
San Bernardino, Ca 924081(909)381-6007
Contractor
Same
Address
Zip
State Lic. City
& Classif. g 314493 1 Lic. # 2120
Designer Frank Gonzales Assoc.
1 3b H. Chapman Ave. Tel.
City I J Zip State
Orange,- Ca 92666 Lic. #
/ LICENSED CONTRACTOR'S DECLARATION !
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section,,
7000) of Division 3 of the Business and Professions, Code, and my license is in ful ,'force and
effect.
SIGNATURE-
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions or 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. h 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.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractors 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. O 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 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 TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the tabor 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. 14069
BUILDING: TYPE CONST. VN OCC. GRP. R3
A.P. Number 604--180-060
Legal Description Lot 11 Tract 25290 Phase I
Project Description SFD Plan 4
Rancho Ocotillo @ La guinta Norte
Sq. Ft.
Size
New ❑
No.
Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
(Estimated Valuation $146,093.00
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Arts in Publ
TOTAL
REMARKS
AMOUNT
664.75
804.00
49.00
160.56
154.40
14_61
24.00
.00
3,236.39
115.18
5.214.47
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: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE 0 Z
ROUGH PLUMB.
BONDING
Y
ARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SD. FT. @
GAS (ROUGH) ul
METER LOOP
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. @
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. @
SERVICE
FINAL INSP.
WALL SO. FT. @
BOND BEAM
DRINKING FOUNTAIN
09 4
i
FINAL INSP.
GRADING
cu. yd.
$ plus x$
URINAL
SO FT @
ROOFING O
/
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
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, 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.
SO. FT. RESID @ 11/4 C
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
CERT. OCC.
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 PLUMBIN 11 1
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 0 Z
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) ul
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL `
GAS (FINAL)
TEMP. POLE
GROUT
WATER ATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. (3
09 4
i
FINAL INSP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
ROOFING O
/
p
J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LhTHING
MESH
INSULATIONISOUND '
FINISH GRADING
FINAL INSPECTION . 3
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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of
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This Certificate issued pursuant to.the requirements of Section 306 of the Uniform Building
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 44-120 Camino Lavanda
Use Classification Single Family Dwelling Bldg. Permit No. 14069
Group R3 Type Construction VN Fre Zone Use Zone SR
Owner of Building�entury Homes Communities Address 1535 South "D" St., Ste. 200
City San Bernardino, CA 92408 By;Bruce Pelletier
Dote: February 13, 1995
Building Official
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