14773 (SFD)P.O. BOX 1504 No. 14773,
Building78-495 CALLE TAMPICO
Address
44-235 - daimino Lavandat LA QUINTA, CALIFORNIA 92253
Owner century Homes- co=unities
'Mailing
Address 1535 S<)U'th `D". Streets Ste. 200
Cityip Tel.
.San Bernardino V__ CA 924081(909)381-6007
Contractor
Same •
ZipI Tel.`'
State Lic. City
& Classif... B 3114473 Lic. # 2120'
Arch., Engr-,
*
..Designer .ank do'nAales'
Easy Cha 'a Avenue '14) 359-6
4Add n 066
pm,
CityZi
lp State
Riversidibth v 92505-- Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions,of Chapter - 9 (commehcing-with'Section
) of Division 3 of the Business and Professions Code, and my license is in full force and -
:effect.
SIGNATURE DATE
'`OWNER -BUILDER DECLARATION
1. hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec.. 7031.5,8usiness and Professions Code: -Any city or county which requires a
permit to construct. after, IlMnive, 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 penally of riot more than live hundred dollars ($500). . . .
0. 1, 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, Buisnessand
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.).
0 1, 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 contractors) licensed pursuant to the Contractor's License Law.)
0 -1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS! COMPENSATION DECLARATION
I hpreby affirm that I have a certificate of consent to self -insure, or a certificate of
workV.s Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
PO?U�Is No. Company
Copy S I
v filed with the city, , 0 Certified copy.is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
• WORKERS' COMPENSATION INSURANCE.
(This section need -not be completed if the permit is for one hundred dollars ($100) valuation.
less.)
I certify that in the performance of thp work for which this permit is- issued, I shall not
employ any erson in any manner, so as to become subject to the Workers' Compensation
ILDING: TYPE CONST.'
A. P. Number
_OCC: OCC: GRP.-
RV
'Lot*31 !Tract25290Phase IIA
Legal Description
',
Project Description $PDPlar.-U
. -Rancho -Odotillo La Quinta.Ncrte
Sq. Ft.
Size ... :3,905
No. No. Dw.
Stories Units
New 0 Add 0 Alter 0 Repair 0
Demolition 0
Estimated Valuation $116,025.00
'PERM11T
AMOUNT
Plan.Chk. Dep.
Plan Chk. Bal.
584.85
Const. T
699.00
Mech.
55,50
Electrical
140.74
-Plumbing
144.00
S.M.I.-
11.60
Grading
20.00
Driveway Enc.
.00
Infrastructure
2t560.28
Arts in- Publiz Places
40.06
Side Setback fromPrope ne
DAMAGES AS PROVIDED FOR IN SECTION 3706" OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES.
TOTAL
4,256.03
REMARKS
Laws of California -
Date -Owner.
TO APPLICANT: ff, after mab7g this Certificate of Exemption you should become
ZONE:
BY:
-NOTICE
subject 'to the Workers' Compensation provisions of the Labor Code, you must forthwith
Distances*
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback
—Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE.WORKERS'COMPENSAT:ON COVERAGE IS UNLAWFUL, AND
m
Side Street Setback f C r Line
to
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,
Side Setback fromPrope ne
DAMAGES AS PROVIDED FOR IN SECTION 3706" OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES.
>
FINAL DATE
INSP
This"'abuilding lierrvilt w fen prbperly-fill4d out, signed.iind validated, and is subject to
is
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'
ISS ed by:
Date t
construction, and hereby authorize representatives -of.-this City to enter the -above-.
mentioned property for inspection purposes.
V�Iidated by:
7 Z
Signature of applicant Date—
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
2ND. FL. SQ. FT. p
STORAGE TANK
YARD SPKLR SYSTEM
SEWER OR SE e;IROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) �l r METER LOOP
HEATING (FINAL)
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
DRAINAGE PIPING
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM Ald
URINAL
ESTIMATED CONSTRUCTION VALUATION $
LUMBER GR.
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
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, 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 ® 1Y4 c
SEWAGE DISPOSAL
SO.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� 1ECTRICAL HEATING & AIR COND. SOLAR
1 .. li+ S tli
o
SETBACK V
GROUND PLUMBING 3 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3 /Air
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE e;IROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) �l r METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) % TEMP. POLE
v
GROUT
WATER HEATE SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM Ald
GRADING '
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING I fIVY
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING !% /
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION UuE
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL