10222 (SFD)x
P.O. BOX 1504
Building 1$--864 La • Palma Drive 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
OwnerAB Associates, L.P
.
Mailing
Address 1535 S. "Bp rat, f200
CityZip Tel.
aeXB $�kI7aICd]Ylt) 92408 714/381-6007
Contractor.
Century Homes Communities
Address
same as above
City lZip I Tel.:
State Ljc. City# 2120
& Classif. 314473 tai Lic
-Arch., Engr.,
Designer Frank Gonzales & Assoc.
Address Tel.
1336 H. Chapman Ave 7141532•-6378
City Zip State
Orange 12666 Lic. # C ()16340
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
�GNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness 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
i, 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).. 1.
❑ l; 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 torr
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) licensed pursuant to the Contractor's License Law.) .
❑ 1 am exempt under fSec.{ B. & P.C. for this reason
r � / 1 •RP F .�
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.)
Poles No. I
I .Company
. n Copy Is filed with the city: O 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 the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the it
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.
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
No. 14222
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Lot ' 147
Legal Description
Project Description
Plan 411 Phase 1
Sq. Ft. 1567 No. No. Dw.
Size Stories Units
ff
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permits does not include block wall or
a.as
IEstimated Valuation 90,175.30
PERMIT
Plan Chk. Dep.
Plan Chk. Bal
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
�S
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:
r
AMOUNT
0.00
!)99.ou'
55. 3 L
IZ9.4%
Me.0O `.
9.10 -I
22 U.
20.00
t1.er . N, i4
`tit
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:
r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CARP. SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
e
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN,
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
FINAL INSP.
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR.® V4c
HOUSE SEWER
VENTILATION
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 %
AUNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE / Jy
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER Oil-6G9'r Teti' =
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
,FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL /b.0; Ah_
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 4B, Lot 147
CITY OF LA OUINTA
~ ° DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Owner CTB Associates, L.P.
Contractor
Permit Number 10222
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-860 La Palma Dr
Permit does not include block
wall or pool
TYPE OF INSPECTION
DATE INSP.
FOUNDATION & SETBACK
2 t
FOOTING STEEL
MAIN GROUND SYSTEM
ROUGH GAS & GAS TEST
GROUND PLUMBING
/ 7 r 7 _ 777
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
7
HEATING & VENT- NC
FIREPLACE
ROOF
% LA
s
1111WA
_.7? .-
BOND BEAM
O.K. TO WRAP
JAY I
2
GROUT O 4' O 8'
FRAMING
fNYtl
/.
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE
HAS BEEN SIGNED
DRYWALL INTERIOR
3
C 2 -
EXTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SSPT4e-T* *
!L
FINALS
ELECTRICAL j.
PLUMBING
FINAL GAS TEST ,2
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4,88
—46S,a*'0'att�/
%zixrt
of
(-or r ?-* - -
I 7Cg
Tit� of 14d'(Quinta
1111itbiR4 end s'safet� 34illiriiiin
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:
Use Classification
BUILDING ADDRESS 78-860 LA PALMA
SINGLE FAMILY DWELLING
Group R3
Type Construction
VN
Fre Zone
Owner of Building
CTB ASSOCIATES,
L . P ,
Address_
Bldg. Permit No. 10222
Use Zone
1535 S. "D" STREET,
#200
SR
l City SAN BERNARDINO, CA 92408 MARK HAROLDI�I •
BY:
11
Dote; APRIL6, 1992
Building Official -
ST IN A CONSPICUOUS PLACE
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