13774 (SFD)t!'�G`trGv
P.O. BOX 1504
Building 45--215 Desert Fax Drive 78-105 CALLE ESTADO
Arlrirpcc LA QUINTA, CALIFORNIA 92253
Owner Century Homes Communities
Address 1535 South '*D" Streets Ste. 200
CityZip Tel.
San Bernardan4 CA 9240 (909) 391-6007
Contractor
Sam
Address
City
State Lic. g 314473
& Classif.
Tela
City 21 �0
Lic. #
Desi ergr
9 Benjamin Aguilar t Assoc.
IN Passero Avenue TJ714) 359-6066
City Zip State
iverside--"& 92505 Lic. # -
I hereby affirm that L.am licensed
,/7000) of Division 3.of the Business
effect. /F
my -1
Section
OWNER -BUILDER DECLARATION 1
-"" I hereby affirm that I am exerMptfrom the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiness�afid Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
I 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) 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 live hundred dollars ($500).
I{ ❑ 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
i 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 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
i 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.)
Policy No,, --Company '
Ca' opy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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, 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. 13774
BUILDING: TYPE CONST. VN OCC: GRP. R3
A.P. Number
Legal Description Lot 17 Tract 23935--4
Project Description SFDPlan 5LX
The Classics at,Topaz
Sq. Ft. 2450 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $137,492.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
641.54
Const.
772.50
Mech.
55:50
Electrical
157.29
Plumbing
144.00
S.M.I.
13.75
Grading
i20.00
Driveway Enc.
.00.
Infrastructure
3 s 055.32
Arts in ftbliC Places
93.73
TOTAL
4 * 953. 3
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
r
FINAL DATE INSPECTOR
Issued by: Date Permit - /'A_
Validated by: f _ a ! A,
t
Validation: � �/ s �, i ` ,�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
v
UNITS
COLL. AREA
SLAB GRADE
Y
ARD SPKLR SYSTEM
2ND FL. SO. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS t
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
DUCT WORK
ROCK STORAGE
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
M ER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SQ. FT. @
WALL SO. FT. @
TEMP. POLE
DRINKING FOUNTAIN
GROUT
URINAL
SO. FT. @
SERVICE
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
BOND BEAM
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. (3
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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 @ 11/a 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 PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS t
SEWER OR
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
M ER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP. (3
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING C�% 3 9
ROOFING 6�
®/ `�
07
/Q /C�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING (�
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION /17
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL