14990 (SFD)i
Building
Address
Owner
Mailing
Address
City.
..Sass
d4t
P.O. BOX 1504 No. 14990
78-495 CALLE TAMPICO
`4'"'360 il amino- Lavanda LA QUINTA, CALIFORNIA 92253
Century Homes Cor=nitiep
1535• South OD Street, Ste. 200
Zip Tel.
� �aarc3i o,, Cs '3240 (509) 381-600
t
jZip I Tel.:
State Lic. City
& Classif.: -,W-114473 Lic. #
Arch., Engr.; :'-:
Designer ; . 1SCa "Gonzala3 ;• Assoc.
Addrss Tel.
L. 6. E..-thabman Ave.
;it Zip State
�raZcrxr r 1
92666 Lic. #
y LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that -1 -am licensed under provisions of Chapter„9:(ce
000) of Di4ision.3-of the Business and`Professions C?Z!_and my lic
BUILDING: TYPE CONST. VN OCC: GRP.
P. Number
Igal Description Lot. 19 Tract 25290 Phase ilia.
oject Description ID
Rancho Ocotillo f La, Qui uta• Forte
2324 Sq. Ft. No.
Size .1936 Sto
No: Dw.
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
7ithSectione an
L. DATE
OWN.WBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bustness 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 thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penally of not more than five hundred dollars ($500). '
11as 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 of completion, the owner -builder will have the burden
- of proving that he did not build 0,
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 propertywhobuilds or Improves thereon, and who contracts for.
such projects with'a contractors) [censed pursuant to the Contractor's License Law.)
O I 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, ora certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poiicy No. Company
O.Copy is filed with the city, . O Certified i:opy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is .for one hundred :dollars ($100)ava/ au tion.
' of less.) - „�'°- -y`
I certify that in the performance of thV work for whichattiis permitRis:issued; I.shall not
employ any person in any manner so as.to become�subjecYto•the_.N/orkers' Compensation
Laws of Califofnia.,e ��r ^ �^ '�✓"
Date' % >K Owner
NOTICEtTOfAPPLiCANT: ff,,eilfir.-making this Certificate of Exemption you should -become
subject to "the Workers' Compensation provisions"o/ the .Lajxir,,,Code,-you must forthwith
comply with such provisions or this pemrtt shall be'd, e6need reGokeC:—
i WARNING: FAILURE TO SECUREWSRKERS' COMPENSATION COVERAGE.IS-UNLAWFUL, AND -
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED.THOUSAND DOLLARS ($IDO,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR .CODE, INTEREST, -AND
I. ATTORNEY'S FEES. - - - -
Ttiis 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 .ofthis city to enter the , above-.
mentioned property for inspection purposes.,-
+�+ Signature of applicant Date
I, ,Mailing Address
II City, State, Zip
Estimated Valuation
$122,765.00
PERMIT
AMOUNT
Plan Chk. Dep:
j
Plan. Chk. Bal.
601.42
const.
7241.441
Mech.. , '
55.50 .'
Electrical '
145.9$
Plumbing
144.0
S.M-I.
12.28
Grading
20.00
Driveway Enc.
; 00
Infrastructure
2,711.93
Arts In Public- Places
55.91
TOTAL
4,469.0 2
—REMARKS
ZONE: BY: - X
Minimum Setback Distances:
Front Setback froYnter Line
Rear Setback,fr�om Rear Pro Line
Side Street ;Setbacl<',Jrom Cent% r Line
Side Setback'from Prorty Line
FINAL DATE
.Issued by:' Date_
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SQ. FT. ® $
UNITS
A.C. UNIT
2ND FL. SO. FT.
SLAB GRADE
YARD SPKLR SYSTEM
ROUGH PLUMB.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
STORAGE TANK
FORMS
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REINF. STEEL
WATER PIPING
NOTE: Not to be used as property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/<c
HOUSE SEWER
FIREPLACE
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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
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V
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALLrA
LATHING -7i,
MESH
INSULATION/SOUND "L6 f
FINISH GRADING
FINAL INSPECTION I
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL