15084 (SFD)Building ,�
Address 4 0 -7$5 Vick lirenz
Owner
Century Homes Crsmc pities
4'4 Q
P.O. BOX 1504
78-495 CALLE TAMPICO
E LA QUINTA, CALIFORNIA 92253
Mailing
Address 15'35 South �� StreetCity .
Zip,', Tel.
San Bern ardin CA 92408 (9019) 38.1-6007
Contractor
Same "
Address _ I
City IZID Tel.:
State Lia City
'' & Classif.:. B• 33:44473 ' Lia # 2120
Arch., Engr., -
. Designer 1'x'r'tfi �sflia` 3 GE :&. 1ilSitl01 a1
.133��T-sFast ChApzran. Ave.. T614) 5325678
City Zip State
O]t ai2tgy ii'"—92666 Lic. #
„LICENSED CONTRACTOR'S DECLARATION.
I hereby.affirm that'I am licensed under provisions.of Chapter 9 (commencing with Section
700)) of Division 3'of.the_BuK•siness and Professions Code, and my license)s in, ull force and
OWNER -BUILDER DECLARATION
1 hereby affirm that*I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bustess 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 permft to file a signed statement that he is licensed pursuant to
Ne provisions of the Contractor's License Law; Chapter 9 (commencing with Section 7000) of
'Divlslon 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 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 wiMh one"year-of completion; the owner -builder will have the burden
of proving that he did not build or reprove 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) [censed 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 Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor'Code.)
• Policy No. - Company
r' ❑ Copy is filed with the city. .O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pemtit is for one hundred dollars ($100). valuation
or less.)
I certify that,in theperformance of thg work for which this permit is issued, I shall not
employ any ppeerson in any manner so as to become subject to the Workers' Compensation
Laws of California.
` Date - Owner
NOTICE TO APPLICANT. ff, after making this Certificate -o/ 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 ADDIT,ION.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'propeAy filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days. ;k
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 herebyf"thorize-representatives ,of this -city to enter the above-.
mentioned property for-irispectiodpurposes._-�
m .res/," f'
Signature of appl�cant��""f_� :..�..�-��i�� Date�'��' .� %f
Mailing Address
City, State, Zip
No. 15484
JILDING: TYPE CONST. IT - OCC: GRP. . R3
P. Number 617-790-001
Igal Description %3t 1' Tract 26152 Phase 1B
oject Description s P.Lan 4GT#
Spinnal,ear Cove -at rake eta Quinta -
Sq. Ft.
Size -
New ❑
No.' No. Dw.
Stories - Units
Add ❑ Alter ❑ Repair ❑ Demolition, ❑
REMARKS
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 Permit
Validated by:
Validation:
r
Estimated Valuation..
$172r560.06
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
74.5 a 82
Const.
. '
895.00
Mech.
89.50
Electrical,
117S.04
Plumbing'
'168.00
S.M.I-
17.30
Grading
20..00
Driveway Enc.
.00
Infrastructure
3,891.81
Ax'En in Pub? = - Plac:ecv-..
192.42
TOTAL
6.190.89
REMARKS
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 Permit
Validated by:
Validation:
r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FSE
1ST FL. S0. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. 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
ROUGH PLUMB. BONDING
n
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH) METER LOOP
LAUNDRYTRAY
AIR HANDLING UNIT CFM
I
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
FINAL INSP.
SQ.FT.GAR ® 3/4c
HOUSE SEWER
ROOFING �`�.�
VENTILATION
��
� 7
/
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE rPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK ry'
GROUND PLUMBIN �UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE
ROUGH PLUMB. BONDING
n
HEATING (ROUGH)
STORAGE TANK
FORMSSEWS
R ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL �7
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus
x$ =$
LUMBER GR.
FINAL INSP.
FRAMING B
FINAL INSP.
ROOFING �`�.�
VENTILATION
��
� 7
/
O
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
f' Q
O/t
SPARK ARRESTOR
UdiX� sY
s ✓/
GAR. FIREWALL
LATHING �� r
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL