14563 (SFD)P.O. BOX 1504 No. 14563
Building 78-495 CALLE TAMPICO
Address 79-320 desert Stream Dr. LA QUINTA, CALIFORNIA 92253
Owner Contury Homes Communities
Mailing
Address 1535 South OD" Street, Ste. 200
CityZip Tel.
San. Bernardino CA. 92406 (909)381-6007
Satz
State LIC. S 314473IL'Ity 2120
& Classif. Lic. #
Desi ;
Designer tngr.,
DesiS$rijariin Aguilar a Assoc.
;
Sd&is ?assero Avenue T11714) 359-6066
ityverside, CA zIp 992505 Lict�
LICENSED CONTRACTOR'S DECLARATION . .
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division Me 3.of sin.Yssta�nd Professions Code, and my license is in full,force nd
SIGNATet
URE J` DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
,reason: (Sec. 7031.5,Bustness 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) 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•ror 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 knprove for the purpose or 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 contractor(s) #tensed 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'91Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy"o. Company
iCopy 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 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.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO- CRIMINAL PENALTIES AND CIVIL FINES UP TO'ONE
I .HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION.3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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:
1 agree to comply with all city and county ordinances and state laws relating'to building
I construction, and hereby authorize representatives -of this city to enter the .above-.
i mentioned property for inspection purposes.
Signature of applicant Date
i ..Mailing Address
City, State, Zip
BUILDING: TYPE CONST. Vn OCC. GRP. R3
A.P. Number
Legal Description Lot'6 Tract 239354-5 Phase 3A
Project Description SFD Plat 5
TheClassics at Topaz
Sq. Ft. 2047 No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition.0
Estimated Valuation1�,� s 247 , 00
I
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. ' .
591.40
Const.
7034*50
Mech.
49.00
Electrical
143.41
Plumbing ' , • I
144.00
S.M.I.
11.92
Grading
20.00
Driveway Enc.
*OQ
Infrastructure
2o683.06
Arts in Public Places
1 48:12
Q
TOTAL
4,400.41
REMARKS
Y
ZONE: BY:
Minimum Setback Distances'. 1
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
1
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
ROUGH WIRING
SEWER OR SEPTIIVA
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
GAS (FINAL) L
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
WATER HEATER SERVICE
FINAL INSP.
WALL SO. FT. ®
BOND BEAM
DRINKING FOUNTAIN
WATER SYSTEM
�+
FINAL INSP. /6 /
FINAL INSP.
GRADING
cu. yd.
$ plus - x$
URINAL
SO. FT. ®
FRAMING
ROOFING 7
VENTILATION
ESTIMATED CONSTRUCTION VALUATION $
pT
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(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,TEMIPERM
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 ® 11/4 c
SEWAGE DISPOSAL
CERT. OCC.
SO.FT.GAR ® 3/4c
HOUSE SEWER
FENCE FINAL
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
ROUGH WIRING
SEWER OR SEPTIIVA
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) L
TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
�+
FINAL INSP. /6 /
FINAL INSP.
GRADING
cu. yd.
$ plus - x$
_$
LUMBER GR.
FRAMING
ROOFING 7
VENTILATION
pT
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION �)
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL