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15751 (CONR)TA. ', v- f.44 • P.O. BOX 1504 No. 15751 Building 78-495 CALLE TAMPICO Address 47-400 C81eo Bay LA OUINTA, CALIFORNIA 92253 Owner Century Homes Communities un 82 Addr"ess 1535 South "D" Street CityZip Tel. San Bernard�.0 CA 9240E (909) 381-6007 Salim Address City lZip State Lic. City & Classif. R 314473 Lic. # 2120 Arch., Engr:, Designer Frank Gonzales & Associates icljRs East Chapman Ave. T1714) 532--6878 City; • -, Zip State otanget;X-V 92565 Lic. # -LICENSED CONTIIACTOR'S DECLARATION F I hereby'affirm'that I am licensed under provisio s of Chapter 9 (commencing with Section 7000) of Division'3.•�osf theBusiness a,d-Professions Code; and my license'JisjJ'n full to ce ands effect. . ;, '—OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Busfness 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 rive hundred dollars ($500). 0 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 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 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) pcensed pursuant to the Contractor's License Law.) ❑ 1 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, or a certificate of Worker's�Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy,ssNo. Company ' 6 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 th? 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 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. OCC. GRP. A.P. Number Legal Description Project Description Restroom Facility ZONE: BY: Minimum Setback Distances: Front Setback from Cent ine Sq. Ft. No. Size 251 Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ F Side Setback f . Property ' FINAL DATE INSA%R Issued by: Da a Vermit, Estimated Valuation $15,261..00 PERMIT AMOUNT Plan Chk. • Dep:. Plan Chk. Bal. 147.65 Const. 171.00 Mech. . 00 Electrical 38.52 Plumbing 63.00 S.M.I. 3.21 Grading Driveway Enc. Infrastructure ay.a- Asa TOTAL y REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Cent ine Rear Setback from R r p. ine Side Street Setback% Cente ine Side Setback f . Property ' FINAL DATE INSA%R Issued by: Da a Vermit, Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE /6 �� 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CAR P. I SQ. FT. TEMP. POLE WALL SO. FT. GROUT DRINKING FOUNTAIN SQ. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRYTRAY 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/a c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER INSULATION/SOUND GAS PIPING PERMIT FEE PERMIT FEE I 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 IA A SETBACK GROUND PLUMUNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE /6 �� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS (:SEWER >R S ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. b / Q/ GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL /U �7 GAS (FINAL) �� $' 9S TEMP. POLE GROUT WATER HEATER- SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING / /J G FINAL INSP. �/ 9S ROOFING '� ;1�1�eFIRE REMARKS: VENTILATION ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION / 9 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL