14783 (SFD)Building
Address
Owner
P.O. BOX 1504
45-450 Desert Air Dr. 78-495 CALLE TAMPICO
LA OUINTA, CALIFORNIA 92253
No. 14783
Century Nomes Communities
Mailing " ' BUILDING: TYPE CONST. Y OCC. GRP. R3
Address 1535 South "D* Street, Fate. 200
, A.P. Number
San p 1BerDardiro ZICA. 924£x.8•. 1
(909) 3.81--60.€97 Legal Description Lot 12 Tract 23935-5 Phase 3t3
Contractor I Project Description 5FD Plan 3
Same The Classics.at Topaz
Address
Tel.:
State Lic. B 314473 (City 2120..
& Classif. Lic. #
Arch., Engr.,
Designer Benjamin Aguilar ; & Assoc.
N%WsPas sero Avenue T624) 3519-5066
C`ty / Zip State
Riverside, CA92505 Lic. #
,LICENSED CONTRACTOWS DECLARATION'"
yl hereby affirm that l'am licensed under Drgvisionwo*Chapter 9 (commencing,4vith Section
�700pjoI Division,3'of the,Business and•Professions.Code, and my license es igffull force and`
OWNER -BUILDER DECLARATION 7 :,-
'
I hereby affirm that I am exempt9fro,m the Contractors License Law for the following
reason: (Sec. 7031.5,BusMess and' Profession Code: Any city or county which requires a
permit to construct, atter, Improv), demolish, or repair any structure, prior To its issuance also
requires the applicant for such permit to We 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).
❑ 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, Bulsness and
Professions Code: The Contractors 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 inprovements are not Intended or offered for sale. If, however, the building
or. improvement is sold within one year of completion, the owner -budder will have the burden
or proving that he did not build or improve for the purpose of safe.)
❑ I, 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.)
O 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.)
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 H the permit Is for one hundred dollars •($100) valuation
.' or less.) '
1 certify that in the performance of the work for which this permit is issued, I shall not
employ anyperson in any manner so as to become subject to the Workers' Compensation
Laws of California. , .
Date Owner
NOTICE TO APPLICANT: ff, after making this Certificate of 'Exemption you should become:
Sq. Ft.
Size. .- 1483.
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ ' Demolition ❑
Front Setback from Center Line
i
Rear Setback from Rear Prop. Line'
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
Side Street Setback froter Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES -UP TO ONE
Estimated Valuation
$$9,648�Gd1
PERMIT
AMOUNT
Plan Chk. Dep.
DAMAGES AS PROVIDED FOR IN SECTION. 3706 OF THE LABOR CODE, INTEREST, AND
Plan Chk. Bal.
5€4.35
Const.' ,
594.50
Mech.
55.50
Electrical
123.52
Plumbing
138.00
S.M.I.
8.98
Grading
24.00
Driveway Enc.
00
Infrastructure
1,991.65
G7
property purposes.
Validated by:
Signature of applicant Date
TOTAL
3,436.60
REMARKS
City, State, Zip • ,
Date Owner
NOTICE TO APPLICANT: ff, after making this Certificate of 'Exemption you should become:
ZONE:
BY:
subject to the Workers' Compensation provisions of the Labor Coder you must forthwith
comply with such provisions or this pemrft shall be deemed revoked.
Mlnlrrlum'SetbaCk Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line'
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
Side Street Setback froter Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES -UP TO ONE
HUNDRED THOUSAND DOLLARS (5100,1X10), IN ADDITION TO THE COST OF COMPENSATION,.
Side Setback from Prop Line
DAMAGES AS PROVIDED FOR IN SECTION. 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
a
This is a building permit when properly.filled out, signed and validated, and is subject to
FINAL DATE
INSP R
expiration it work thereunder is suspended for 160 days.
IA
I certify that I have read this application and state that the above information is correct.
Issued by:
Date 'r/ �I}mjt
I agree to comply with all city and county ordinances and state laws relating to building
construction, hereby
iii 1
and authorize representatives -of this city to enter the above=..
i mentioned for inspection
G7
property purposes.
Validated by:
Signature of applicant Date
Mailing.Address
Validation:
City, State, Zip • ,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. @ $
UNITS
COLL. AREA
SLAB GRADE
Y
ARD SPKLR SYSTEM
2ND FL. SO. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
DUCT WORK
ROCK STORAGE
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. @
GAS (FINAL)
WALL SO. FT.
DRINKING FOUNTAIN
SO. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING yr
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
r
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 @ IA c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
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 A PLUMBING 2tCTRICAL HEATING & AIR COND. SOLAR
SETBACK
US
GROUND PLUM 7j
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
.. _
=$
LUMBER GR.
FINAL INS3t/ (��
FRAMING yr
FINAL INSP.
ROOFING /
r
O
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING J
MESH
INSULATION/SOUND J f/
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL