14623 (SFD)� T
tt'�N�w
r ,
414
P.O. BOX 1504
78-495 CALLE TAMPICO
Building 7� . 6Z W4 J6 %Z1 LA OUINTA, C
Owner Century Roues; Conmunities
Mailing '
Address 1535. aoUth aflt Street
CityZip Tel.
San Bernardino CA 92408 1(909)381-6007
Contractor
Address
ty .
No..34623-
ALIFORNIA 92253
BUILDING: TYPE CONST: OCC: GRP. R3
A.P. Number
Legal Description' Lot ,16 Tract 26152
Project Descriptionx
Spinnaker Cove ..at Lake La Quinta
State Lic.,1:"33 City 2,20
& Classif. _ Lic: # Sq. Ft. No..
Size 1925 Stories
Arch:, Engr., 1wran.k..gdnza1 es &. Associates
Designer New ❑ Add ❑ • Alter ❑ Repair ❑
No. Dw.
Units
NIT'S East .phavi n Ave..
114)532-6878
Permit, does not include b31
or •. pool.
City
flr� 22t:: 4'.A
Zip
-926564
State
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 Code,. and my license is in full force and '
effect. "
i
'
-
SIGNATURE - DATE
OWNER -BUILDER DECLARATION$1-1.4o.,641.,00
1 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 asigned.statement that he is licensedpursuant to
the provisions of. the Contractor's License Law, Chapter 9 (commencing with Section 7000) or -
' 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).
❑ 1, 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
or proving that he did not build or 6nprove 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 contractors) jlcensed pursuant to the Contractor's License Law:)'.
- O I am exempt under Sec. - B. 8 P.C. for this reason
Estimated ValUatlOfl .
PERMIT -
Plan Chk. Dep. 250.00.
Plan Chk: Bal.
Const.
Mech.
Electrical -
Plumbing
.
S.M.L.
..
Grading
•
Driveway Enc.
Date Owner
Infrastructure
Arta" in Ptalal:ILc Places
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance,.or a certified copy thereof. (Sec: 3900; Labor Code.)
Policy No. Company
❑ Copy is filed with the city. . ❑ Certified copy is hereby furnished...
TOTAL 4.260.76
:Demolition ❑ .
AMOUNT -
CERTIFICATE OF EXEMPTION FROM -REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need -not be completed i1 the permit is for one hundred dollars ($100) valuation W
. or less.) - .
I certify that in the performance of thg work for -which -this permit is issued, I shall not
employ any pperson in any manner so as to become. subject to the Workers' Compensation
Laws of California.
Date �Owner
NOTICE TO APPLICANT: fj, after making this Certificate of Exemption you,'shoukd become
subject to the woikers' 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 THE41ABOR-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 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
ZONE: BY:
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'
tRI Validated bY:
r
Ir FEB 0 3.1995
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SQ. FT. ® $
UNITS
A.C. UNIT
2ND FL. SO. FT.
SLAB GRADE
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SO. FT.
SEWER OR SEPTIC TANK
DRAINAGE PIPING
WALL SD. FT.
DUCT WORK
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
REINF. STEEL
FLOOR DRAIN
MECHANICAL FEES
TEMP. POLE
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER HEATER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRYTRAY
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
�'J/✓/��--�`NJ/ �� �Jy�IYI*ST�/✓/1!/'/�!!!%Z
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID a 1+/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FIRE ZONE ROOFING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE -T 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
SEWER OR SEPTIC TANK
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. g
FRAMING
FINAL INSP. �/ S
ROOFING
�'J/✓/��--�`NJ/ �� �Jy�IYI*ST�/✓/1!/'/�!!!%Z
REMARKS:
VENTILATION
/
U`iCS�rZc
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING,
FINAL INSPECTION 9 ��
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL