14998 (SFD)Building
Address 44_355 Camino Lavanda
Owner Century domes Comnunities
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Mailin
Address 1535 South OD" Street, Rte. 200
City Zip Tel.
San Rernardin �, Ca 9240E (909) .381-6007
Contractor
Same
City
State Lic. City
& Classif. B 334473 Lic. # 2120
Arch., Engr.,
Designer Frank .Gonzales Assoc.
AdT.TIs6 • $. Chapman Ave. Tel.
CiState
O zip 92666 Lic.#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing,with Section
701x1) of Division 3 of the Business and Professions Code, and my lice/n�se is in!f IMorce and
effect. _ .. �� �� _.....w—' '�-.. ��i
SIGNATURE••'^ " - •.� '" - r DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am'exempt from the Contractors 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 file 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 anproves 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) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. 8 P.C. for this reason
Date f^_�/ Owner "*
WORKERS' COMPENSATION DECLARATION
I hereby affitm that 1 have a certificate of consent to self -insure, or a certificate of
Workers 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 if 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
f.1! i
Date Owner -
NOTICE TO APPLICANT: ff, 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 ($100,0)0), 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 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 Address
City, State, Zip
No. 14998
BUILDING: TYPE CONST. OCC. GRP.;
P. Number
R3
Legal Description Lot 27 Tract 25290 PHase IIB
Project Description SFD $ an 2X
Rancho ocotillo @ La Quinta Norte
Sq. Ft. No. No. Dw.
Size 1907 Stories Units
New ❑ Add 0 Alter ❑ Repair ❑ 'Demolition ❑
m
Estimated Valuation
$116,133.00
PERMIT
AMOUNT
Plan Chk. Dep.
d
Plan Chk. Bal.
564.85
Const.
699.00
Mech.
55.50
Electrical
140.74
Plumbing
144.00
S.M.I.
11.61
Grading
20.00
Driveway Enc.
00
Infrastructure
2,562.73
Arts in Public Places
40.33
TOTAL
4,258.76
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear : (o Line
Side Street Setback enter 'ne
Side Setback fromr p rtLin
FINAL DATE I PEC:,00�
Issued by: Date Perrtidit
r
Validated by: 19`? f
Validation:
m
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT_,p $
UNITS
COLL. AREA
2ND FL. SQ. FT. p
/
`/
YARD SPKLR SYSTEM
POR. SQ. FT. p
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. p
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT. p
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SO. FT. p
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
LUMBER GR.
IKITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. p c
BATH TUB
SQ. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID p 1+/a c
SEWAGE DISPOSAL
SQ:FT.GAR p 3/ac
HOUSE SEWER
SPARK ARRESTOR
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
SETBA&
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
/
`/
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
`�
SEWER OR SE TA
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
VENTILATION
40
1-771-N
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION71,
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL