14771 (SFD)44
P.O. BOX 1504 N o . 14 771 �.
Bdsg 44-295 Cimino L�iVanda LA QUINTA, CALIFORNIA978-495 CALLE 02253
Adddreress '
Owner Century Homes Communities g3 I
Mailing BUILDING: TYPE CONST. -OCC. OCC. GRP.
Address ].535 mouth " ". Street, Ste. 200
A.P. Number
City Zip Tel. r ' Lot 29 Tra--t 25290 Phase IIA
San Bernardin,w , CA 9240$ (909)381-6007 Legal Description
Contractor
Address.
City lZip I Tel.:
State Lic. City
& Classif. B 314473 Lic. # 2120
Arch., Engr:, '
Designer •$i Gonzales & Assoc.
-
Isrsls -East Chapman Avenue T614) 359-6065
City Zip State
Aversidc, CA 9250.5 Lic. #
*LICENSED CONTRACTOR'S DECLARATION
1 a
I hereby affirm thatm licensed under provisions of Chapter 9'(commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and -
'�`ef f ect.
31GNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: .(Sec. 7031.5,Busfness 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) 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 rive 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 or 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) (fcensed 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.)
PolicCompany
11 B Copy is filed with the city. ❑ 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
or less.)
1 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
alifornia.DateOwner
NOTICE TO APPLICANT. N, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. •
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
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,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. •
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 certity 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.
Project Description SKY Plan 3XL
Rancho ocotillo @ La Quinta .Norte
Sq. Ft. No. No. Dw.
Size -2746 •- Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
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:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
Estimated Valuation $161,260.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
709.21
Const. 1
856.50
Mech.
55.50
Electrical
169.73
Plumbing
162.00
S.M.I.
16.13
Grading
20.00
Driveway Enc. - -
00
Infrastructure
3,578.07
Arts in Public Places
153.15
TOTAL t
5,72-0.90 f
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:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
2ND FL. S0. FT.
COLL. AREA
YARD SPKLR SYSTEM
it
ROUGH PLUMB.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
WIRING
DRAINAGE PIPING
WALL SO. FT.
ROCK STORAGE
DRINKING FOUNTAIN
SO. FT. ®
GAS (ROUGH) / f%
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
REINF. STEEL
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
SERVICE
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
REMARKS:
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 //ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
I
GROUND PLUMBIN 21
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
it
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR S C A Wf/ROUGH
WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
C'
GAS (ROUGH) / f%
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) (
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. ,
FRAMING (
FINAL INSP.
ROOFING(
J
�
we- n Q
{/�U� V
/J
REMARKS:
VENTILATION
FIRE ZONE ROOFING`!
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/
LATHING /
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESfINIT1ALS
GARDEN WALL FINAL