14770 (SFD){1 '
+k fi P.O. BOX 1504 No. 14770
Building i n 78-495 CALLE TAMPICO
CZi1:Qi
Address 44-325 no Lav nda LA QUINTA, CALIFORNIA 92253
Owner Century Homer Communities es
BUILDING: TYPE CONST. � OCC. GRP. R3
Mailing
Address 1535 South '31)0 Street, Ste. 200
A.P. Number
City Zip Tel. Lot 2$ Tract 25290 Phase IIA
Sari SE3£T'#c' rdinC o CA -924081(909)381-6007 Legal Description
Contractor Project Description SQA Plan 4
SWIM Ranckao 4cAtil.l.10I . La Quinta Norte
Address
ty ,t Zip
State Lic" City
& Classif..: - Bi '314•$.73 Lic. # 2120
Arch., Engr.,
Designer .Prank .Gonzales 6 ,Jissoc.
..3 5 East Chapman �,�renue T�e�i M0359-6.066
City7CA'iP9250.!, State
-Riversiuei Lic.#
LICENSED CONTRACTOR'S DECLARATION
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
000) of Division 3 of the Business and Professions Code, and my license is in full force'and
ftect.
SIGNATURE - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt 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, atter, 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 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 enproves 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.)
❑ 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) #censed pursuant to the Contractor's License Law.)
O 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 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 thf 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.
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 3706 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 if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above i formation is correct.
I agree to comply with all city and county ordinances and state la relating to building
construction, and hereby authorize representatives -of this city t enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. - • No. No. Dw.
Size 2436 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:
Validation:
/%
Estimated Valuation $146,073.00
PERMIIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
664.75
Const.
$04.00
Mech.
49.00
Electrical, , " .
160.56
Plumbing
150.00
S.M.I.
14..61
Grading
20.00
Driveway Enc.
.003
Infrastructure
3,236.37
'Arts in Public Places
115.18.
TOTAL
5,214.470
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:
/%
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
S�
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
FOUND. REINF.
DRAINAGE PIPING
WALL SO. FT.
HEATING (FINAL)
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER SERVICE
FLOOR DRAIN
MECHANICAL FEES
BOND BEAM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING ,
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
� C+�
77
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
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 /-EOCTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING I
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
S�
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. L
FINAL INSP.
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FRAMING ,
ROOFING
VENTILATION
� C+�
77
REMARKS:
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