10192 (MISC)�r
Building
4
P.O. BOX 1504
78-105 CALLE ESTADO
44-445 Las Vistas Dr? v-- LA QUINTA, CALIFORNIA 92253
Owner
CTB Associates,, L.P.
Mailing
Address 1535 S. nDu 5t #200
City Zip Tel.
San Bernardinc 92438 714/381a-6007
Century Boxes Communities
Address
smote as above
City lZip Tel.:
State Lic. City
& Classif. 314473 BI Lic. # 2120
Arch., Engr.,
Designer Frank Gonzales & Asspc.
Address Tel.
1336 B.'Chapman Ave 714/532-6878
City Zip State
Orange' 92666 Lic. # C 016340
LICENSED CONTRACTOR'S DECLARATION
I hereby afflri that I licensed under provisions of Chapter 9 (commencing with Section
%T of Dlvi'slorf 3ko US�emBusiness and Professions Code, and my licens is in full force and
effect. is f 1,— 14 �P 1
_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, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a .signed statement that he is licensed pursuant to
. the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or.
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 rive 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
of proving that he did not build or improve for the purpose or sale.)
❑ 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 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.)
Po4Cy No..
Company
'I 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 (5100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any parson 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
Ihereby 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-,' hereby authorize representatives -of this city to enter the above-.
mentio property for inspection purposes.
ignature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST
No. 10192
Number
II Description Lot 245
.ct Description Model 3C
OCC: GRP.
Sq. Ft. No' No. Dw.
Size 1400.Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Permit does not include block wall or
pool
stimated Valuation
83,22G. 40
PERMIT
-
AMOUNT
Plan Chk' Dep.
250.00 L
Plan Chk. Bal.
Const.
567.50
Mech:
55.5:
Electrica[
•. 1`24 . 66
Plumbing
144.00
S.M.I.
8.40
Grading
2101.00
Driveway Enc.
20.00
Infrastructure
18.72.59
1
14
a :! l.Y:�y fi 8+ •f Cd 3 r1t.,. _ .i1✓K � , �'v+.1
TOTAL
3299.4b
304`3.46 .
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
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. I SQ. FT.,® '
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKL'
R SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM. FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3yic
HOUSE SEWER
FINAL INSP.
ROOFING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL:'
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK000,
P
_ _GROUND PLUMBING/,( UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK/ Ol OUGH WIRING.
DUCT WORK
'ROCK STORAGE
FOUND. REIN
GAS (ROUGH) i �' "� I f 2 METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL AIV
1111116&V
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. / GG
�
FRAMING ` 3 Ql
FINAL INSP.
ROOFING
(�
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
P
L"
FIREWALL 7"Alr
LATHING 1A (z/
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL