13763 (SFD)TAty/
P.O. BOX 1504 N o . 13763
Building 45-090 Desert Hills Cour78-105 CALLE ESTADO
Address tLA QUINTA, CALIFORNIA 92253
Owner Century Homes Communities
Mailing BUILDING: TYPE CONST. VN OCC: GRP. R3
Address 1535 South OAR Street, Ste. 200
A.P. Number ,
Cit
San Bernardino zlpC.A 92408 T ( 909) 381,6007 Legal Description Lot 12 Tract 23935--3
Contractor • Project Description SFD Plan 3XC
Sammi The Classics at Topaz
Address
City Zip Tela
i
State Lic. City
& Classif. B 314473 - Lic. # 2120 Sq. Ft. No. No. Dw.
Arch., Engr.,'
Size 1654 Stories. Units
.Ben amin A uilar & Assoc.
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
t'ffis Passer>o Avenue Te(714) 359-6056
C_ityy Zip State
! R� L' z's]:c ,, 9 92505 Lic. #
LICENSED CONTRACTOR'S DECLARATION s�
41 hereby affitm that I am'licensed under provisions of Chapte`r91commencing with Section
tt7000) of Division 3 of the Business and Professions Code, and my licenseisin full forceanndp,j
1 ffect�' � _,v �"'✓"�......,"�.r"'�" ;iS.+�.rs""�,�'.'.�EP'6:.�
SIGNATURE 'DATE
OWNER -BUILDER OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt,f"roam the Contractors License Law for the following Estimated Valuation
$99,577.00
reason: (Sec. 7031.5,Business anVProfessions 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 file a signed statement that he is licensed pursuant to PERMIT AMOUNT
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 Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than live hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 533.11
do the work, and the sfructure is not intended or offered for sale. (Sec. 7044, Buisness and Const. �' ' f137 . 50
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, CC
provided that such improvements are not intended or offered for sale. If, however, the building Mech. J:7 50
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical ��
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- Plumbing t 144.00
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 .S.M.I. 9.75
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading 20.00
❑ I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc. .00 '
Date owner Infrastructure 2,120.44
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 Company ,
opy is filed with the city. ❑Certified copy is hereby furnished.
TOTAL 3,653.41
CERTIFICATE OF EXEMPTION FROM REMARKS
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 person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemptionyou should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, - you must forthwith Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
�+ Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
• 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. Issued by: Date Permit
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-. c r
mentioned property for inspection purposes. Validated by: (�
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
SEWER Gla ARM
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
I
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN
URINAL
SO. FT. ®
FINAL INSP. f
GRADING
cu. yd.
$ plus x$
ESTIMATED CONSTRUCTION VALUATION $
LUMBER GR.
WATER PIPING
NOTE: Not to be used as property tax valuation
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FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAR. FIREWALL
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.
SQ. FT. ® c
BATH TUB
FINAL INSPECTION q
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
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
SEWER Gla ARM
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP. f
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING �� / �I Ff
ROOFING
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REMARKS:
VENTILATION
'
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
C
LATHING 4,r
MESH
i
INSULATIONISOUND/O
FINISH GRADING
FINAL INSPECTION q
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL