14788 (SFD)j
s
! P.O. BOX 1504
Building 45-485 Desert Air Dr. 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner Century Mmes Communities
IBUILDING: TYPE CONST.*
Mailing
Address x.535 South Rp" Styetr Ste. 200
City Zip Tel:
San leraardino Cid 92608 (909) 381-60
Contractor
Same
Address
City Zip Tel.:
'state Lic. $ 316673 City 2120
& Classif. Lic. #
Arch., Engr.,
Designer 3 �3,E4_IZ.�Ztmin ;99 %U1ar ASSOC.-&
-
NsYsPass.er® .x'41 Z Tf71411359-60
kACity Zip State
7'erside,a- CA'- 92=505' Lic. #
..�. -
I hereby affirm that I am
000) of Dlvisio63 of the I
9
A.P. Number
No. 14788
OCC: GRP.
R3
cii Legal Description Lot 19 Tracie 23935-9 Phase 39
Project Description SFD. . Plan 5L
rhe..Claasi cs at Topaz
66
OWNER -BUILDER DECLARATION e'
Thereby affirm that I am exempt from the Contractor's License Law, for the following -
reason: (Sec. 7031.5,Buslness:and Professions Code: Any city of county which requires a
permit to construct, alter ylmprove, 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).
❑ 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 enprove for the purpose of sale.)
❑ 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) flcensed pursuant to the Contractor's License Law.)
O I 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.)
Po%lWicyP-C
ompany
Copy is filed with the city. O 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 thg work for which this permit is issued, I shall not
employ any peon in any manner so as to become subject'to the'Workers' Compensation
Laws of Californirsa
Date Owner
NOTICE TO APPLICANT: If, atter 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. '
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST. OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This Is abuilding permit when properly filled out, signed and validated, and is subject to
expiration If work thereunder is.suspended for 180 days. .
I certify that 1 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
Malling Address
City, State, Zip
Sq. Ft. X162 No. No. Dw.
Size. Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimated Valuation
$133,522.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
�, •
Const.
5B
5*1
Mech.
Electrical
4
Plumbing
f
S.M.I.
Grading
n
Driveway Enc.
00
Infrastructure
2
986
2
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Prop. Line
Side Street Setb om ter Line
Side Setback firope��
FINAL DATE INS9MR OR
Issued by:
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIWU FEES
1ST FL. SO. FT. p $
UNITS
COLL, AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
HEATING (ROUGH)
STORAGE TANK
FORMSSEWER
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. p
DUCT WORK
ROCKSTORAGE
GAR. SO. FT. p
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. p
GAS (FINAL)
WALL SO. FT. p
DRINKING FOUNTAIN
SO. FT. p
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
v
LAUNDRY TRAY
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. p c
BATH TUB
SO. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID p 1 Va c
SEWAGE DISPOSAL
SO.FT.GAR p 3/4c
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 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING 1
UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSSEWER
OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
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. I�
FRAMING S S
FINAL INSP.
ROOFING
VENTILATION
p ) ,/� L
—Pj /
v
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING '
MESH
INSULATION/SOUND r
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL