15093 (SFD)fl
f44,
P.O. BOX 1504
Building# C 78-495 CALLE TAMPICO • '
Address 47 -965i -Via Nice LA QUINTA, CALIFORNIA 92253.
Owner `' t
Century . nomes Ct➢mE]ni..' ies
, , y
Irf T
Address 1535 Sa�rt?a D Street
CityZip Tel.
San Bernard>� n CA 92408 (909)381-6007
Contractor
s>aml_o
Address
No. 15033 ..
11LDING:'TYPE CONST.'_ W.OCC: GRP.
P. Number 617-790-x+23
Igal Description Lot 23 Tract 26152 Phase 2A
oject Description S Pian* 41G
Sp3.mia.ker Cove al-, 'rake La Qiiinta
City.
Zip
Tel.` • .
,
State Lic.
City
;
& Classif.. �B 31447'3
Lic. # � �s�a.
S Ft. No. : ' No. Dw.
Q- :.�
. 27'41 - -stories - Units
Arch.,-fngr.,Size
Designer Frank G_i�l>:Zai e & AS.faOCI' ateS .
New ❑ Add ❑ Alter ❑ ' Repair ❑ Demolition ❑
XAdd JT . $ast ,ChAPMan Ave.
714) 932--6878
CityZip
State
Or <3t3t� F ,,
92666
Lic. # -
-LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under -,provisions of Chapter 9 (commencing with Section
7000) of Division .3'of the Business and'Professions Co^9derind my license is,in fujl:force•antlr
- effect. ,.s' ;,�s'a •• .!_`.—^'",.—•-",.a^�`�1 e"":''�•�!��r ��l �!
-SIGNATURE ?'DATE
T' OWNEWBUILOER DECLARATION
I hereby affirm that I am axe rr p: f m the Contractor's License Law for.the following
Estimated Valuation'
reason:. (Sec. 7031.5,Business and. Professions Code: Any city or county which requires a
,
I -
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
. PERMIT . - . " AMOUNT ,
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/.
_
Division 3 o/ the Business and Professions Code, or that. be is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by *any applicant. /or a permit
Plan 'Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars (8500).i
my
Bal.�1
Plan Chk.- S9 • t/\\\
❑ I, as owner of the property, or 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
Const. r' " -856.50
-
Professions Code: The Contractor's License Law does not appy to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
y McCh., t �'r. ,�9 fj
provided that such Improvements are not intended or offered /or -sale. I/, however, the building
or improvement is sold within one•year of completion, the owner -builder will have the burden
.
Electrical �� 172 .04
of proving that he did not build or hnprove for the purpose. of sale.) i
Plumbing 168.00
❑ 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
-
S.M.I. - .16 • 12
does not apply to an, owner of property who builds or -Improves thereon, and. who contracts for
such projects with a contractors) Ucensed pursuant to the Contractor's License Law.),
i
.
Grading 20.60*
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc. 00
`
Date owner
Infrastructure 3,62 065
Arts in Public Places 152.96
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.).
-
Po�ioY'Na¢Company
(w.
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 5,621.62
'1 F'.y itf.' Y• J.-
CERTIFICATE OFEXEMPTION;FROM ��F J �};,
REMARKS
WORKERS' COMPENSATION INSURANCE Xl
(This section need not De completed it the permit `is for one hLndred- dollars ($,100) vat etfon
-
' or less.) •, * :`it,�137 "'°`-
I certify that in the performance of 1hF work for which this permit is issued, I`shall not
employ any in any manner so as 14, becorne,subject to the Workers' Compensation:;
r� r
,
poison •
Laws of California.
Date
Vthfs
,
ONE:- BY:
_owner
Owner
NOTICE TO APPLICANT: d, after.'malring Certificate o/ Exemption you -should become
subject to the Workers' Compensation provisions of the Labor code,= you must forthwith
comply with such provisions or thls permd shall be deemed revoked.
_
'.Minimum Setback Distances:
*
'Frorit''Setback from Center Line
`Rea`r Setback from Rea�P'Op.,Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND
Side Street. SetbaCk,frUkenter',LI e^
SHALL SUBJECT'AN"EMP,L`OYER'TO CRIMINAL PENALTIES AND!CIVILyFINE&UP`TO,.ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF,COMPENSATION ,,.
�/
Side Setb ck fr( I —'i_rty Line l" .
DAMAGES`AS PROVIDED FOR IN SECTION 3708 OF'THE LABOfi'CODE;''INTERESL,-AND '
ATTORNEY'S FEES'` na '�4 .` t '. ,.
�• ,.. r' Re. `.
This Is a building permit when properly filled out signed and validated, and -is subject
expiration Ib"work thereunder is suspended for 180 days. +�`
- FINAL. DATE INSPECTOR
Z•\' 'V., l -
~
I-certifylthat I have read this application and,"slate'that thie above information is correct.
Issued "` Date Pertnitq..
s I agree'to comply with all city- and, county ordinances arid state laws relating to building
construction, and hereby authorize representatives.. -of this city to enter the above;.
.b
Y ti, no
/.I.
mentioned property for inspection .d
-Validated by
poses 1{,
ignature of applicant + Date'-;
.Mailing Address
Validation.'
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
FOR. SO. FT. ®
GAR. SO. FT. ®
CARP. SO. FT.
WALL SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) METER LOOP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED.
OTHER APPJEOUIP.
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
FINAL INSP.
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
REMARKS:
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
MIT FEE
PERMIT FEE
DBL
TOTAL FEES t
MICRO FEE'
MECH.FEE EPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK /
GROUND PLUMBING / r UNDERGROUND.
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. `BONDING
'HEATING (ROUGH)
STORAGE TANK
FORMS
< SEWE R ROUGH WIRING
:DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP.
HEATING (FINAL) _
OTHER APPJEOUIP.
REINF. STEELGAS
,29
(FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
'FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
/J
FRAMING
FINAL INSP.
ROOFING G'"
'
5
AV
�.
REMARKS:
VENTILATION
FIRE ZONE ROOFINGV��/
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 1J
MESH
INSULATION/SOUND �Q
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL