12795 (SFD)r-�
_f
P.O. BOX 1504 N o . 12795
Building 78--625 Sanita Drive 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Century Homes Cminun%ties
Mailing BUILDING: TYPE CONST.. OCC: GRP.
Address 1535 South "D" Street, Ste. 200
CityZip Tel.
San Be: nardirao C. 92408 (909) 381-'6007
Contractor
Same
Address
State Lic. B 314473 (City 2320
& Classif. Lic. #
Arch., Engr.,
Designer Benjamin Aguilar & Assoc.
Sffis Passero Avenue T17103 9-,,,,
city Zip State
Riverside, 92505 Lic. #
1 hereby aff.irm that Lani licensed under lirovi
300) of Division 3 f=the Buslnesr s .and..P_rofes;
ff.,
t /
9 (commencing with Section
nv-license is in full force and
_,�:: 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 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).
O 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.)
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) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. 8 P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I here 6ffirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Gompensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy o. 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 if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg 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.
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.
1 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
A.P. Number 604-174-006
Legal Description Lot 171 Tract 23269 Phase 7A
Project Description SFD Plan 5X
dsc"3.. Qt1inta Del.Rey
Sq. Ft. 2010 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$114,058.00
PERMIT
AMOUNT
Plan Chk. Dep.
255.00
Plan Chk. Bal.
328.44
Const.
692.00
Mech.
_
49.00
Electrical
141.63
Plumbing
144' i&0 .
S.M.I.
11.50
Grading
20.00 "
Driveway Enc.
.00
Infrastructure
2, 528.06
Arts in Pu
11c Places
3' . i
TOTAL
4,199.78
3e 94947V
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
.11
Side Street Setback from Center Line
Side Setback from Property -Line
r
FINAL DATEINSPECTO/RI
Issued by: Date 1 -7Permit_
Validated by: '^ �. MAR 0
t.
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
h �'
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INSPECTOR'S SIGNATURESIINITIALS
YARD SPKLR SYSTEM
2ND FL. SO. FT.
REMARKS:
SLAB GRADE 3
ROUGH PLUMB.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
FORMS
SEWER
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
GAS (ROUGH)
•J
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P.' SO. FT. ®
WALL SO. FT.
REINF. STEEL
DRINKING FOUNTAIN.
TEMP. POLE
URINAL
SO. FT. ®
WATER HEATER
SERVICE
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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
MIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE EPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE
PLUMBING ELECTRICAL
HEATING & AIR COND. SOLAR
SETBACK 44-
GROUND PLUMBING
WATER SYSTEM
FINAL INSP.
UNDERGROUND
A.C. UNIT
COLL. AREA
If+
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INSPECTOR'S SIGNATURESIINITIALS
P/ _`
7 Z 9/�/
REMARKS:
SLAB GRADE 3
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
•J
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
LUMBER GR.
FRAMING 9
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
1 cu. yd.
$ plus x$ =$
ROOFING
�(
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTIONAt
CERT. OCC.
FENCE FINAL
GARDEN WALL'FINAL
If+
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INSPECTOR'S SIGNATURESIINITIALS
P/ _`
7 Z 9/�/
REMARKS:
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This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building!
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following.
BUILDING ADDRESS 78-625 Sanita Drive
�? ! use Classification Single Family Dwelling Bldg. Permit No. 12795
Group R3 Type Construction VN Fire Zone Use Zone SR
Owner of Building Century Homes Communities Address 1535 South "D" Street, Ste_ ?on
City San SernarAi nn CA 9240A
li Bruce Pelletier
By.
I�July 18, 1994 yyi Date:
Building Officio)
-- rOeT IN A aONQTICUOU! MACE
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