14572 (SFD)44
P.O. BOX 1504 No. 14572
Building 78-495 CALLE TAMPICO
Address 79-365 Desert Stream Dr. LA QUINTA, CALIFORNIA 92253
Owner Centuryr BQm:s Co=aunities
BUILDING: TYPE CONST: • VN. OCC_ GRP_ R3
Mailing
Address 1535 South "W" Street,, Ste. 200
City Zip ITel.
San Bernardino , CA 92408 (949) 381-600
Contractor
SaltlE: .
Address
Zip
State Lic. 314473 City,
& Classif. Lic. #
-Engr.,
Designer BenjaZt; in Aguilar & Assoc,
Designer ,
43 stis Passero• Avenue Te�714) 359-606
City, Zip State
Riverside, CIA 92505 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under Drovisions of Chapter 9'(commencing with Section
7000) of Div,isrion 3 of Ife usin /s and Professions Code, -and my license is in full orce and
effect:
SIGNATURE / ./ •DA E
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason:, (Sec. 7031.5,Business 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 file a signed statement that he is licensed'pursuant to '
the provisions of the Contractor's License taw, 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
sub/sots 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 improve for the purpose of sale.)
O 1, 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hpreby 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.)
Poli No. Company
Copy is filed with the city. .0 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 pt California.
Dater Owner
NOTICE TO APPLICANT." d, 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 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
Mailing Address
City, State, ZIp f
A.P. Number
Legal Description Lot 30 Tract 23935-5 Phase 3A
Project Descriptions Plan 5X
The Classics at Topaz
6
Sq. Ft. 2047
Size.
No.
Stories.
No. Dw.
Units
New ❑ Add 0
Alter ❑
Repair O Demolition ❑
•
Estimated Valuation
•$119,247.00
PERMIiT
AMOUNT
Plan_ Chk. Dep.
Plan Chk. Bal.
59.1.40
'Const.
709.50
Mech.
49.4.0
Electrical '
143.41
Plumbing
144..00
S.M.I.
1.1.92
Grading
20.00
Driveway Enc.
00
Infrastructure
2,683.06
Arts - in Public Places
48.12
TOTAL
4,400.41
REMARKS
„ ,r
ZONE: BY:�r
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. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
2ND FL. SO. FT. p
STORAGE TANK
YARD SPKLR SYSTEM
SEWER OR SE T% ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) METER LOOP
HEATING (FINAL)
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
CAR P. SO. FT.
FINAL INSP.
WALL SO. FT.
WATER SYSTEM
DRINKING FOUNTAIN
SO. FT. ®
LUMBER GR.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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 ® 1Ve c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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 j ELE AL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING ' UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE T% ROUGH WIRING
DUCT WORK
ROCK STORAGE
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 L`
FRAMING W/ ;,
FINAL INSP.
ROOFING
VENTILATION
^_ / J/L // J—��
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND /
FINISH GRADING
FINAL INSPECTION(,,, f
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL