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14993 (SFD)P.O. BOX 1504 N o . 14993 Building 78-495 CALLE TAMPICO Address 44-450 Camino Lavanda LA OUINTA, CALIFORNIA 92253 Century Homes Conmuni.ties Address 1.535 Sduth "D" Street, Ste. 200 City ZipTel. . San Bernardir o, Ca 92401 {90911383--600 Contractor Same' IAUUFU55 State Lic. City & Classif. g •314473 Lic. # 2120 Arch., Engr., Designer Frank, Gonzales Assoc. e � Add TJ6 $.. Chapma n. Ave. Tel. CityZip State Orange, Ca . 92665 1Lic.# LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under'provisions of,Chapter 9 (commencing with Sectiontr 7001) of Division 3 of the Business4fid Professions Code, and my license is4ri full force and effect. e� .r,/ ..�..��.%i!. /"`� .r J! �'+. 1 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, alter, 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 bunds 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 or improve for the purpose or 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 property who builds or improves thereon, and who contracts for such projects with a contractor(s) Qcensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. a 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 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 U,the permit.is'for one hundred dollars,($100) valuation or less.) j I certify that in the performance of.thp 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 o1 California_."".......... y "- Date�� OwnerJ-� NOTICE TO APPLICANT: -8, after making this Certificateol,Exemption you should. become"" subject to the Workers' Compensation provisions of"the-Labor Code,,.you ust 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 ($10),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 BUILDING: TYPE CONST.- VN OCC. GRP. R3 , A.P. Number Legal Description Lot 22 Tract 25290 Phase 1X}3 SFD Project Description Plan 3R R,iincho Ocotillo La Quints Norte Sq. Ft. Size .2216 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $132,481..00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 621 .50 Const. 755.00 Mech. 55.50 Electrical 15-1.18 Plumbing 134.00 S.M.I. 13.25 Grading 20.01 Driveway Enc. .100 Infrastructure 2,930.54 Arts in Public Places 81.20 TOTAL 4 , 77 S . 17 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line '% 1 Al Rear Setback from Rear Prop�� Side Street Setback from Ce t the Side Setback from Pro Line FINAL DATE INSP CTOR Issued by Validated Validatior CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL. SO. FT. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® DUCT WORK DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN SO. FT. ® 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ plus x$ LAUNDRYTRAY AIR HANDLING UNIT CFM ( FINAL INSP. 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 ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/.c 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 1 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 ROUGH 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 f,f au GRADING cu. yd. $ plus x$ =$ LUMBER GR.//JJ ( FINAL INSP. FRAMING 1l FINAL INSP. ROOFING l o( � ` Fy( / /j�� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 6 124 MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL