14992 (SFD)Buildin
Address 44-420 Cassino Lavanda
Owner Century Homes Conmuni.tiea
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
mailing
Address 1535 .South "D" Street, Ste:. 200
City ZipTel.
San Sernardi o, Ce 92409 (909) 301-'680
Contractor
See
Address
' IZiP ITel.:
State Lic. City
& Classif. $. 314473 Lic. # 21.20
Arch., Engr:, Frank.Gonzales les Assoc.
Designer
AdTrJ6 E. Chapman AVe. Tel.
Cityi " - Zip State
®range, -_Ca-_ 92666 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm thati,ain 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
ff.ctI. '4.7
e
SIGNATURE" -' DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness 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 penally of not more than five.hundred dollars ($500).
O 1, 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
i or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or irnprove for the purpose of sale.)
I O 1, 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 contractors) (lcensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. li P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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 No. 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 If the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued,A shall,not"
employ any ppers9n in any manner so as to become subject-to,the warkkeers%Compensation
Laws of California.',,,:
Date / !' : Owner �-
NOTICE' TO' APPLICANT: N, • after making this Certftkate of Exemption you should become
subject to the Workers"Compensation provisions of the Labor Code, you must forthwith'
comply with such provisions or this pemtit 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 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. 14992
BUILDING: TYPE CONST. Vt' OCC. GRP. R3
A.P. Number
Legal Description Lot 21 Tract 25290 Phase 1IB
SM
Project Description Plan'
Rancho -Ocotillo @ La Quinta Norte
Sq. Ft. No. No. Dw.
Size 1907 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition -0
Estimated Valuation $116,133.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. 584.85
Const. 699.00
Mech.. 55.50
Electrical 140.74
Plumbing 144.00 _
S.M.I. 11.61
Grading 20.00
Driveway Enc. .00
Infrastructure 2t562.73
Arta in Public Places 40.33
TOTAL 4 0 258.76
REMARKS
ZONE: BY: '
Minimum Setback Distances:
Front Setback from Centev (1-1 e
Rear Setback from Rear
XP,�Line
Side Street Setback fromenter nem
Side Setback from Pr�e[ty ne
FINAL DATE IN _,,FCTOR ri
Issued by: Date Permit /
Validated bv: //�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINu FEES
1ST FL. SO. FT. @ $
UNITS
2ND FL. S0. FT.
COLL. AREA
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
HEATING (ROUGH)
GAR. SO. FT, @
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
SEWER OR SE R`�
DRAINAGE PIPING
WALL SD. FT.
DUCT WORK
DRINKING FOUNTAIN
SO. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION $
METER LOOP
WATER PIPING
NOTE: Not to be used as property tax valuation
OTHER APPJEOUIP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.0OOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GROUT
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
WATER HEATER
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN 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. @ c
BATH TUB
FRAMING
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1 V. c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
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 SE R`�
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) V11
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
i AV
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
VENTILATION
ol-3ohj-OL
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND J
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL