14636 (SFD)�����1 iii/. •' "
P.O. BOX 1504 N O. 4636
Building 78-495 CALLE TAMPICO " •
Address 79-194. Kara Co -d t LA OUINTA, CALIFORNIA 92253
Owner Century Homes Communities
Mailing
Address :1535 Sout nEll" Street,,. Ste. • 2-00
City Zip Tel.
Sam Beroarc�s. a , _ A 92408 (909)381-6007
Contractor .
_ SaM
Address
City IZip' ' ITel.
State Llc W -114i �3. ]C'ty12120
&Classlf : L"ic.
Arch.,,. Engr;;
Designer '- jc'1t." .,Aguilar & Assoc*.
Alf res • •........ - • - Te .
Passero Avenue�714� 359-606
City Zip State
92505- Lic. #
,LICENSED CONTRACTORS DECLARATION
Thereby affirm that.i'am licensed under. provisions.of Chapter 9 (commencing with Section
7000) of , .Gision 3 of the Business and:Professions: Code, agd.my license !s.ih full force and
BUILDING: TYPE CONST. ,• OCC: GRP. R3
A.P. Number
Legal Description Lot, 39. Tract 26188 Phase '3 "
Project Description" uC`:"b Alan 3K
Del Rey at La:Ouinta Norte
Sq. Ft. 1618 " No. No. Dw.
Size Stories Units -
New ❑ Add ID. Alter ❑ Repair ❑.
ter.., ��r+ ,-
` SIGNATURE . _'.+•�"'� � .;_-,,.—"
.. OWNER=BUILDER DECLARATION
1 hereby affirm that I am exempt from the .Contractor's•License Law for the following •
.. reason: (Sec..703LS,Busfnass. and Professfons Code:- Any city ,or 'county. which requires. a.'.'; -
Estimated Valuation aEfr�• An S .vp���
s ,, ;99.p 031.00 .
-
••PERMIT -
permB to construct, alter,'fmprove, demolish, or repair any structure, prior to Its issuance also.
- 'requires the applicant for such permit to files 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 o/ Sacton. 7031:5 Dy 'any applicant !or a permit
" subjects the applicant to's civil penahyof not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their•,sole compensation, will
' r do the work, and the structure is not intended or offered for sale. (Sec. 7044 Buisness and
" Plan Chk. Dep,,'. - -
Plan Chk. Bal.
-
Grading
Professions .Code; The' Contractor's License Law does, not apply to an owner of property who
bulids 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'I, as owner of the property, am exclusively contracting with licensed contractors to coo-
strucl 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) jicensed pursuant to theContractor's License Law.)
- O I am exempt under Sec •- B. 8 P.C. for this.reason
Const..
M2Ch.., -
' Electrical,-
Plumbing
, S.M:I. -
-
Grading
Driveway Enc.
Dale owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self•insure or a. certificate of '
REMARKS
AMOUNT "
..520.00 .
626.00
128.47
13800
• 9.60.
20.00
.00 •
2,160.69
Workers Compensation Insurance; or a certified copy thereof. (Sec. 3800, Labor:Code.)
•-
Poll o. .Company
0EI Copy is filed with the city, O Certified copy is.hereby furnished.
TOTAL
3 66 6. 3 4
REMARKS
CERTIFICATE OF EXEMPTION FROM'
WORKERS' COMPENSATION,INSURANCE
(This section need :not be completed t the permit is for, one hundred dollars- valuation
• ' or less:) ... _ ..
I certify that in the performance of th0 work for which this permit is issued, I shall not
' employ any persomin any manner so as to become subject torthe Workers' Compensation_- .
' Laws of California
-
Date Owner
NOTICE TO APPLICANT: If, alter making -this Certificate, of Exemption- your should'become."ZONE:
.. subject' to the Workers'.. Compensation provisions of .the -Labor Code, -you must. forthwith.
comply with such provisions or -tris permit shall be deemed revoked. - - -
$Y: '
•- - -
M,Inimum Setback Distances:. .. -
'
Front Setback from Center Line
Rear Setback -from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL, AND '
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES.AND,CIVIL FINES' UP TO'ONE
-
Side Street Setback.from Center Line.. °
,' 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 -
Side Setback from Prop L
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. .
FINAL DATE
INSP R
. - 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::'
'Issued by:-
^'
Validated by:
Date emit
O
Signature of applicant Date
.Mailing Address
Validation:
-
'–.�
City, State,. Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINv FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. S0. FT.
GAS (ROUGH)y {l
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
BOND BEAM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP: Qjfl
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
////
ROOFING r—
/
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SPARK ARRESTOR
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SO.FT.GAR ® VAc
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 A fLECTRICAL 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 110WIR
ROUGH.WIRING
DUCTWORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)y {l
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEIOf
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP: Qjfl
FRAMING
FINAL INSP.
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ROOFING r—
/
( (/
y'z_
i /��LATHING J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
MESH
INSULATION/SOUND
FINISH GRADING
i
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL