12791 (SFD)Building 78-665 Sani.ta Drive
Address
Owner Century Homes Comunitfes
4 (4
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 1535 South ODO Street, Ste. 200
City Zip Tel.
San BernardiniJo CA 92408 (909)381-600
Same
Zip
State Lic.,B 314473 (city 2120
& Classif. Lic. #
Desi ergr
9 Benjamin Aguilar & Assoc.
Adors Passeaco Avenue Te(714)359-606
City, Zip State
Riversideo CA 92.505 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that.l am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code land my license -is in full force and
SIGNATURE DATE
OWNER-BtfLiil& 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, 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 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
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
or 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 contractors) licensed 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
Worke/op
'mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Company
❑Ls filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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 lhp work for which this permit is issued, I shall not
employ any �erson in any manner so as to become subject to the Workers' Compensation
Laws of Cali ornia.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate or 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
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 tolcomply 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. 12T92
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 604--174.002
Legal Description Lot 157 Tract 23269 Phase 7A
Project Description SF'D Plan 5XL
La Quinta Del Regi
Sq. Ft. No. No. Dw.
Size 2467 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $136,144.00
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Arts in Pub1I o F
TOTAL 4
REMARKS
0.
AMOUNT
390.46
769.40
49.00
157.48
156.00
13.61
20.00
•VO
39063.25
90.36
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from PrgDer4yyjne
FINAL DATE INS
Issued by: Date Hermit_
Validated by: O 3
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES'
IST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE ?j
YARD SPKLR SYSTEM �
2ND FL. SQ. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
SEWER
ROUGH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. SO. FT. ®
HEATING (FINAL)
WALL Sq. FT.
REINF. STEEL
DRINKING FOUNTAIN.
GAS (FINAL)
TEMP. POLE
URINAL
SO. FT. ®
GROUT
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
f
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
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 17
GROUND PLUMBING I
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ?j
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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 6
FINAL INSP.
ROOFING .
VENTILATION
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r j
2�
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REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK 'ARRESTOR
GAR. FIREWALL ?�
LATHING /
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
AW
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AN
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This 'Cerfiftcdte':iifi.u,ed,pursuant to the.requiMm $ection 306 of. the_
enti 6f Uh 6i
Code certifying that at the time -of issuance this structure -was In compliance with the variouijVK
'-
ordinances of the City. regulating building use.
construction or For the followirk
04
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IN D D r
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Sin le Pir�i- No. 2
e Family Dwelling W
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"Use Zone
R3 Type Constructi
'Group on
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Owner of Building Century "Homes C OMMU n i t i'e' 13' Add r .151 5� � z" R 6 ti J- h 'In" StrPet., eta 2`6 n,
San Bernardi no'--li, -CA .92408
city.
-7,77777 r
f�i-
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T Ju y 1994
fill
Building Official
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iso
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