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15657 (SFD)pieaae note Owner and Contractor info ation have been rever6ad. 1504 0LA OLC-. G A7 LG L0f � P.O. BOX �lAM Address Building * 79-955 ..y Blvd. LA OU NTA, CALIFORNIA 92253 Rancho Capiatrano Corp;. Address 79-687 Country Club Dr. #201 CityZip Tel. Bermuda Dunes, C.A 92201 (619)345-7755 Contractor gND II I 56-340 PGA Blvd. Citta Quinta, a ip 92253 Tel.: State Lic. City & Classif. B-597975 Lic. # 1969 Arch., ' B R G Architects Inc. Designerer � Ad,8"borporate Park No. 15657 BUILDING: TYPE CONST. VN OCC. GRP. R-3 A.P:'Number 769-730-012 Legal Description Parcel 2 Lot 5 Tract 28194 Project Description SY Madel Plan 3C PGA Mast Herit, +qe Collection Sq. Ft. No. No. Dw. Size 3441- Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 10261-1795 Permit d Cit Zi n17= emp. Yrvin,i.j�,, CA I p 92714 Lic.State # C 6885 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section' 7000) of Division 3 . f the Bus'ness and P fessions Code, and my license is i full force and effect. Lt qs 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,Business and Professions Code: Any city or county which requires a permit to construct, after. 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 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 subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). O 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. N, however, the building or improvement is sold within one year of completion, the owner -budder wig 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) #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's C6mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy N • . Company •opy is filed with the city. ❑ 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 ($100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of. Exemption you should become . subject to the, Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO. ONE HUNDRED THOUSAND DOLLARS ($I00,000), 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 it work thereunder is suspended for 180 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 not include b RrMtpR _ ZONE: BY: Minimum Setback Distances: Front Setback froFn Center Line Rear Set�b�q"om Rear�Prop. Line Side StZet Setbaclz_from Side;'getbac+� Center Line Pli '�rtyNLi e Estimated Valuation 4286,383-00 PERMIT AMOUNT Plan Chk. Dep.- 250.00 Plan Chk. Bal. 816.49 Const. r 1,294.00 Mech. 130.00 Electrical 223.60 Plumbing 211.50 S.M.I. 28.64 Grading 20.00 Driveway Enc. 00 - Infrastructure 61000,00 Arts in Public Places 465.96 TOTAL 9,440.19 9,190.19 RrMtpR _ ZONE: BY: Minimum Setback Distances: Front Setback froFn Center Line Rear Set�b�q"om Rear�Prop. Line Side StZet Setbaclz_from Side;'getbac+� Center Line Pli '�rtyNLi e FINAL DATE INP,ECTOR� =e Issued by: \� ate Per Validated by: Validation: •M CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS EWER R SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® AS (ROUGH METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SQ. FT. GROUT WATER HEATER WALL SD. FT. FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP,,2/S'-IS FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION 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 ®1'A c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE IPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR BACK •- ROUND PLUMBI '[/� UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING -HEATING (ROUGH) STORAGE TANK FORMS EWER R SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. AS (ROUGH METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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,,2/S'-IS FRAMING ` n f� FINAL INSP. ROOFING �— S p w �lG ]-�� I.Z- /I -9S REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL WJLI.ATH MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION (//� !/ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL