14558 (SFD)A
Tit y''
P.O. BOX 1504 No. 14558
Building 79�37g Desert--Stge� ;Dr. * LA QU1NTA, CALIFORNIA 92253
Address
Owner Century Homes Communities, ,
Mailing
Address 15.35 , SCauth, "D" .Str6et, Ste*.-
City Zip Tel:".... .
San ' 8� z ii ®, CA .921t0b (909).3.8:
Contractor .
Sante~:
Address
BUILDING; TYPE CONSTr' OCC: GRP.
I
A.P. Number
L�ga�l Description Lot -1 'bract 23935.5 Phage 3A
Project Description °.�1�i1
.The Classics . a:t.' Topaz
City
Zip ...
Tel.: '. .
State Lic..: 314473
City .�.Q
& Classif.-. t
Lic. #.
Sq. Ft.
1421
No No. Dw.
' Arch., Engr. Ay
-.Bealmt,,•a� in' Agid i ar, -. Awa- a a
Size
Stories Units
_
Designer
New ❑ - Add ❑
Alter ❑'". Repair ❑ Demolition -0
AddresU59 Avenue
Tel. (714.) 359—
066 .
.7aS'sera
CityRiverside,
JZip�i �g A
}State
LICEN5FD CONTRACTOR'S DECLARATION '
I hereby affirm that I am fcensed under.provisions of Chapter 9 (commencing with Section. '
7000) Divisiyyyyyon �ness'andrPrc
of 3 of t 8 essions Cpde, and my license,is innf/full,force and
t.. effect.
DATE
SIGNATURE d DATE
-
...7' OWNER -BUILDER DECLARATION 1
hereby I from License Law for following
Estimated Valuation' 652.,00
I affirm that am exempt the Contractor's the
- -Code:. Any
>F
reason: (Sec. 7031.5,Bus/7ess and Professions city. or. county.' which requires a•
permit:to construct, alter, improve, demolish, or repair any structure, -prior toits issuance also
requires toe applicant for such permit to the a signed_statement'that he is licensed pursuant to
---k" r
• V_
.. . �•� 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
the Any Section 7031.5 by `any for.
-
Plan Chk. Dep:
aa C '
- .�E 9 75
.for alleged exemption. -violation of applicant a -permit
subjects the applicant'to a civil penalty of not more than five hundred dollars ($500). ! - ' ' -
'
Plan Chk. Bal. -
„7a
- - 581.00 -
❑ 1, as owner of the property, or my employees with wages as,their sole compensation, willC
do the work, and the structure is not -intended or offered for sale. (Sec. 7044, Buisness and
COrtSt.
55 �JCg
Professions Code: The Contractor's License Law does ;not apply to an owner of property. who
- a
builds .or improves thereon and who does such work himself or through his own* employees,
-provided
Mech.' '
� � -
_ 12
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
Electrical -
- - 144.00- '
o
�'.. f proving that he did not build or 6nprove for the purpose of sale.) - . '
O'1, as ownerof the property, am exclusively contracting with licensed contractors lo'con•
Plumbing
8.67
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•.
20.00
- such projects wfth'a contrdctor(s) (fcensed pursuant to the Contractor's License Law.) . - - -
- -
Grading
O I am exempt under Sec. - B. & P.C. for this reason -
Driveway Enc.
.00.
Date Owner
Infrastructure ' ; .'
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L;'.f; m 949.73'
WORKERS' COMPENSATION DECLARATION
I hereby affirm that l.have a certificate of consent to self•insure,,or a certificate of.
Worker'sompensation Insurance, or a certified -copy thereof. (Sec. 3800, Labor Code.)
Policy o• Company .
Copy is filed with the city._ O Certified copy is hereby furnished.
TOTAL
I 3,376'r-45
CERTIFICATE OF EXEMPTION FROM
REMARKS
r i
WORKERS' COMPENSATION INSURANCE
'need"not
/�r 1'
,1 '-
'
(This section be completed N the permit is for one hundred dollars ($100) ,valuation:.
I certify that in the performance of the work.for which:this permit is'issued,il shall not
-
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j
employ any.,person in any. manner so as to become subject to the.Workers"Compensation
Laws of California - ',
y
' �,� �. • 1i �•
Date Owner
NOTICE .TO APPLICANT: 'U, after making this .Certificate or Exemption <you should .become •.
'subject
ZONE:
' BY:
to the Workers' �Compensation provisions of the Labor Code; you : must forthwith
comply with such rovisionsorthis ermitshall bedeemed
-•
-
Minimum Setback Distances: V
revoked..
.
Front Setback from Center Line ;
Rear.Setback from Rear Prop. Line -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
`-
Side. Street- Setback from Center Line ' -
SHALL SUBJECT AN EMPLOYER TO'CRIMINAL PENALTIES AND.CIVIL-FINES UP�TO ONE
- .HUNDRED•THOU5AND.DOLLARS ($100,000);[N ADDITION TO THE COST OF.COMPENSATION,
Side Setback from Property Line
DAMAGES AS PROVIDED. FOR IN -.SECTION 3706 OF.THE LABOR CODE; INTEREST,AND '.
ATTORNEY'S FEES. .
' - -. --- -rm-
"FINAL DATE
INSPECTOR
This Is a'building peit when properly filled out, signed and validated, and is subject.lo
expiration it 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.ahis city to. enter-the:above•.
mentioned property for inspection purposes.
:Validated by:
Signature of applicant Date:'
. Mailing.Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINV FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE -31
7w J
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROCK STORAGE
FOUND. REINF.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APPJEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO. FT.
WALL SO. FT. ®
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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 ® 11/4 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 E CTRICAL HEATING & AIR COND. SOLAR
. 77A
SETBACK
/
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE -31
7w J
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
r
SEWER OR SEPTIC T N ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) f TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.Z/6/f
FRAMING
FINAL INSP.
ROOFING
VENTILATION
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REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING L
MESH
INSULATION/SOUND l�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL