14561 (SFD)P.O. BOX 1504
Building78-495 CALLE TAMPICO .
Address 79-340 Desert Stream Dr. LA QUINTA, CALIFORNIA 92253
Vwner . Century Homes Communities I
Mailing
Address 2535 South *D- Street, Ste. 200
City Zip Tel.
San. Bernardino, & 92408 1(909)381-6007
Contractor
Address
State Lic. B 314473 (City 2120
& Classif. Lic. #
Desig tngr.,
Designer Benjamin Agrilar 6 Assoc.
5159 SPassero Avenin: T614) 3595066
City Zip State
R3Versidelii -CA 92505 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am,lic�nsed under provisions of Chapter 9 (commencing with Section
.7000) of DivisioQ_3_o/f the` GsinessTanGd Professionrs Code, and my license is in full force add �je
effect. �id".�� r;�i eYJl��/,r'ww•" /•�i��/
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's. License Law for the following
reason:. (Sec. 7031.5,Busi7ess and Professions Code: Any city or county which requires a
permit to construct, atter, 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
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Divlslon 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, Bussness 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 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
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec.- B. & P.C. for this reason
Dale Owner
WORKERS' COMPENSATION DECLARATION \\
I he'reby affirm that I have a certificate of consent to self -insure, or a certificate of.
Work er's�Compensation Insurance, or a certified copy thereof. (Sec. 3800,�Labor Code.)
Policy,Plo. Company
tl7lCopy 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 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., ff, 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
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 160 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. 14561
BUILDING: TYPE CONST. V OCC. GRP. 113
A.P. Number
Legal Description Lot 4 Tract 23935-5 Phase 3A
Project Description - SFn Flan 3X
The .Classics at .. Topaz .
ZONE: BY: til t
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
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
-Validation:. -
Sq. Ft.
Size 1694 -
No. No. Dw.
Stories Units
New ❑ Add ❑
.' Alter ❑ Repair ❑- Demolition ❑
Estimated Valuation
$101#681.00
. I
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
544.90
Const.
646.50
Mech.
55.50
Electrical
131.11
Plumbing
144.00
S.M.I.
10.17
Grading
20.00
Driveway Enc.
.00
Infrastructure
20253.10
-Arts in PUEUc
Places 20*UO
TOTAL
3 , 82 5.2$
ZONE: BY: til t
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
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
-Validation:. -
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
I C41
SEWER OR SE C
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
ROCK STORAGE
FOUND. REINF.
DRAINAGE PIPING
CAR P. I SD. FT.
GAS (ROUGH) all A
METER LOOP
WALL SO. FT. ®
HEATING (FINAL)
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
GROUT
FLOOR DRAIN
MECHANICAL FEES
SERVICE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WA SHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
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
I C41
SEWER OR SE C
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) all A
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 INSP.
FRAMING /
FINAL INSP.
ROOFING
S
7
I /) `
pv�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND I!t?
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S S16NATURESIINITIALS
GARDEN WALL FINAL