10193 (SFD)r • '� r
3- Q
4
P.O. BOX 1504 N Q . 1019 3
Building 7&105 CALLE ESTADO
Address 78-855 La Palma Drive LA QUINTA, CALIFORNIA 92253
C.T'B Associates, L.P.
Address 1535 S. "D" St #200
City Zip Tel.
San Berna-diro 92408 1 714/331-6007
Homes Communities
Address
same as above
City lZip Tel.:
_&'&I -a Ssif. 3144,73 B1 Lia # 2124
Arch., Engr.,
Designer 24r€ nk Gonzales & ASSOC.
Address Tel.
1336 E.. Chapman. Ave 714/532--687
CityOZip State
range 92550 Lic. # C 015340
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) t. of Division 3 of the Business and Professions Code, and my license is in full force and
.effec
SIGNATURE 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, atter, 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 1, 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 imp 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-bulider 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 corn'
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner or property -who builds or improves thereon, and who contracts for
such projects with a contractor(s) 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
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Poriry No. Company
dO 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 the 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, alter 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 it 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 Lot 116
Project Description Phang Plan 3C
Sq. Ft. 1400 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit- does not include block wall or
'3001
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 Property Line
FINAL DATE INSPECTOR
Issued by: ' Date ' Permit
Validated by:
Validation:
Estimated Valuation
i3r22- 44
PERMIT
AMOUNT
Plan"Chk. Deli. y '.
250.00
Plan Chk:'Bal.
Const:
557,E
Mech.
55.5
Electrical
Plumbing
144.00
S.M.I.
8.40
Grading
20.00
Driveway Enc.
20.00
Infrastructure
1812.59
TOTAL
REMARKS
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 Property Line
FINAL DATE INSPECTOR
Issued by: ' Date ' Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. @ $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO, FT. ®
CAR P. SO. FT.
WALL SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $..�
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM `
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation'
ROUGH PLUMB,
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® V4c
HOUSE SEWER
FRAMING
FINAL INSP.
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
GROUND PLUMBING 2-tAJ
DERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB,
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEW
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
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL ,
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Phase 1, Plan 3C, Lot 116
�A% CITY OF LA OUINTA
a DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
5642246
24-HOUR NOTICE FOR INSPECTIONS
Owner 'CTB Associates. L.P.
Contractor Century Homes Communities
Permit Number 10193
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-855 La Palma Drive
Permit does not include block
wall or pool
TYPE OF INSPECTION DATE INSP.
FOUNDATION b SETBACK ;Z c,7 -
FOOTING STEEL C
MAIN GROUND SYSTEM
GROUND PLUMBING /7@1 & 9-,
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS 3 GAS TEST i
HEATING 8 VENT -A/C
FIREPLACE Ctty
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
L_
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR 71
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE d GATE
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS„
JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
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This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying thot of the time of issuance this structure was in complionce with the various
ordinances of the City regulating building construction or use. For the following:
Use Classification
Group R3
BUILDING ADDRESS 78-855 La Palma
SINGLE FAMILY DWELLING
Type Construction VN
CTB ASSOCIATES, L.P.
Bldg. Permit No. 10 19 3
Fre Zone Use Zone SR
Owner of Building Address 1535 S. "D" STREET, 4200
City SAN BERNARDINO, CA 92408 By: Mark Harold
74�
Dote: APRIL 2, 1992
Building Official
POST IN A CONSPICUOUS PLACE
'�l '1t.
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