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14768 (SFD)uut�,tc� P.O. BOX 1504 ! Building Address 44-36 Ca .no ' �'.,�t'i�anda LA QU NTA, CALIFORNIA 92253 ' Owner Cent`J ry ' $ale: ,,Comunitief Mailing Address 3535 South "DO -Street, Ste. 200 CityZip lTel- San,Bernardino_01 92408 1&909) 381-6007 Contractor Sante Address _ City ' = Zip Tel.: No. 14768 BUILDING: TYPE CONST: �nq OCC: GRP. R3 A.P. Number Legal Description Lot 17 Tract 25290 Phase 111A SFD Project. Description Plan 4G Rancho Ocotillo•@ La Quinta Norte State Lic. City & Classif... B•- 3.14,47:3. : Lic. # 2120 Sq. Ft.No. Size 2728. _ Stories Arch:, Engr., tiank_- d6r.z'a1'r Designer &•F®C Arch. New O AddO isTas a�� hr�t it�n Ave. ed14) 359-6€:66 City _ F?2666 State ' UzaYige.I dA -1. Lic. # ;. LICENSED CONTRACTOR'S DECLARATION 1 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 full force and effect. ' SIGNATURE DATE ' OWNER BUILDER DECLARATION Estimated Valuation�'1 I hereby affirm that I am exempt from the: Contractor's License Law for the following 7 729.00 No. Dw. Units Alter ❑ Repair El . , reason: (Sec.. 7031.5,13usiness 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 asigned* statement that he is -licensed pursuant to the provisions of the Contractor's License Law. Chapter 9 (commencing with Section 7000) of ' - 4.PERMIT Plan Chk. Dep. ' 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 . Plan Chk. Bala Const. ' 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.. Mech.- builds or knproves thereon and who does such work himself or through his own employees, .• I provided that such. improvements are not intended or offered for sale. If, .however,. the building. Electrical or Improvement is sold within one year of completion, the owner -builder will have -the burden of, proving that he did not build or lmprove for, the purpose of sale.) Plumbing 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 taw does not apply to an owner of property who builds or improves thereon, and who contracts for S. M. 1. - - such projects with'a coniractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt -under Sec B.4-P.C. for this reason Grading Driveway Enc. `..Date owner Infrastructure Arts in -Public I car tify•that l have read this application and state that,the above information is correct. Issued by% WORKERS' COMPENSATION DECLARATION tI 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 N !�- 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 N 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 NOTICE TO. APPLICANT: N,' after ` making this Ceitifrcate of Exemption you should become' - suAlect to the Workers' Compensation - provisions • of the 'Labor Code, you must' forthwith •. comply with such provisions or this permit shall be deemed revoked. TOTAL REMARKS es ZONE: BY: Minimum Setback Distances: Front Setback from Center Line -Demolition O AMOUNT 174 .©0 3.593.12 City, State, Zip Rear Setback from Rear Prop. Line . WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND. Side Street Setback from Center Line SHALL SUBJECT AN EMPLOYER TO. CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,00(3); IN, ADDITION TO THE COST OF COMPENSATION, Side. Setback from Property Line DAMAGES AS PROVIDED FOR IN SECTION 3706 OF•THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. FINAL DATE INSPECTOR "This is abuiiding permit when properly filled•out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days.: I car tify•that l have read this application and state that,the above information is correct. Issued by% Date Permit 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.. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. p ROUGH PLUMB. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. DRAINAGE PIPING WALL SO. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN SQ. FT. ® GAS (FINAL) S TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT 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 WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMING �( S GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM REMARKS: 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/e c SEWAGE DISPOSAL SQ.FT.GAR ® 3/.c 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 PLUMBINGTRICAL HEATING & AIR COND. SOLAR x—rf�D7 SETBACK GROUND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTI A ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. _ GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) S TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING �( S FINAL INSP. ROOFING � .%/]�� � F � REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND (Z ) FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL