14061 (SFD)T4.ht 4 64�Q"
Building 44-'155 Camino Lavanda
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
'.."` Century Homes Communities I
mailing
Address 1535 South *DO Streets Star. 200
City Zip Tel.
San Dertardin>< , Ca 924081(909)381-6007
Contractor
same
! Address
City lZip Tel.'
State Lic. City
& Classif. B 314473 Lic. # 2120
Arch- Engr.,
Designer , Frank Gonzales Assoc.
Adel. s, / Tel.
�e S. so Ave.
City Zip, State
Orange, CBS-- �' 92656 Lic. #
LICENSED CONTRACTOR'S DECLA_RATIUN
f I hereby affirm that I am licensed under provisions of Gliapter 9 (commencing with Section
7000) of Division 3 of the Business and=Professions,Co/de,,and my license is in
lull force'and
effect/ �ir� fi f-/ fi
SIGNATURE ��- �" -✓ `�' j DATE
OWNER•BUILDER DECLARATION
I hereby affirm that I;am %xempt 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, after, 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) or
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
j 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
1 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 Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
I such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
' ❑ lam 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 i1 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 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 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-
Mailing
ateMailing Address
City, State, Zip
No. 14461
11LDING: TYPE CONST. VN OCC: GRP
P. Number 604-180-051
R3
Legal Description Lot 2 Tract 25290 Phase I
Project Description SFD plan 3
Rancho Ocotillo @ La Quanta Norte
Sq. Ft. 1936 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
. ' x
Estimated Valuation $132,765.40
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
601.42
Const.
720.00
Mech.
55.50
Electrical
146,92
Plumbing
144.00
.S.M.I.
12,2R
Grading
20.00
Driveway Enc.
Q0
Infrastructure
2,711.93
Arta in Public Planes
56.91.
TOTAL
4,469.02 %
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: —Date Permit
Validated by:
Validation:
0
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
REINF. STEEL
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GROUT
WATER HEATER SERVICE
DRAINAGE PIPING
CAR P. I SQ. FT. ®
BOND BEAM
WATER SYSTEM
WALL SQ. FT.
=$
DRINKING FOUNTAIN
SQ. FT. ®
FRAMING
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FENCE FINAL
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 HEA. ING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING i%II'r UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �J
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) r TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. /
FRAMING
FIINAL INSP.
ROOFING 9
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING.
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
■1
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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 44-155 Camino Lavanda
Use Classification Single Family Dwelling Bldg. Permit No. 14061
Group R3 Type Construction VN Fire Zone Use Zone SR
Owner of Building Century Homes Communities Address 1535 South "D" St. , Ste. 200
Cit San Bernardino, CA 92408 Bruce Pelletier
�
BY:
Dote: February 2, 1995
Building Official
POST IN A CONSPICUOUS PLACE