15205 (PAT)QUM
P.O. BOX 1504 No. 15205
Building ?85 78-495 CALLE TAMPICO
Address 47-4-015 Via Firenze LA QUINTA, CALIFORNIA 92253
Owner Century hones Ceymunitaes
•
Mailing
Address 1535 South a.D* Street
CityZip Tel.
.San Bernardino CA 92408 (9091'381-6007
Contractor
•a�it�ai'2� '
Address
City
Zip
Tel.:
r
State Lic. '.
City
& Classif..
8'314473
Lic. # . 2120
Arch., Engr,,:.
Designer -
'-
Fralnk...G6nzaleS &
. .
ASSOCiateS
1YRS East 'Chapman Ave.
T1714) 532-687$
City
' orange,
'
ZipState
92666
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby effirm'that I am'licensed under provisions of Chapter 9 (commencing with Section
000) of Division 3,of''the Business and Professions ;Code; and my license is in ffuulbforce�aend
nNATIIRF -_r./' or+%"•-"" s..�"'• .�7r• - nATF
I hereby affirm that I am exetnpt•froni the Contractor's License Law for the following
reason: -(Sec. 703 1.5, Business and Professions Code: Any clty,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 rile 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). •.
' ❑ 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 appy 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 budding
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 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) Licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hemby rm that I have a, certificate of consent to self -insure, or a certificate of
Worker'spensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy o- Company
p 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 permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the 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: ti,. 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 ($100,000), 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 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
BUILDING: TYPE CONST. - OCC..GRP.. R8,
A.P. Number 617-790-001
Legal Description Lot 1. `haat 26152
t
oject Description sq.' ft. deck
Spinnakez C oVb . at Lake La Quints
Sq. Ft. No.
Size Sto
New ❑ Add -El Alter ❑
t. .
Estimated Valuation
PERMIT
Plan Chk. Dep. -
Plan Chk. Bal.
Const.
Mech. '
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
V 15084 11 —
No. Dw.
Units ,
Repair Demolition"❑
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop�,Line
IN
Side Street Setback from, nt Line
Side Setback from Prop
y Line
FINAL DATE INSPECTOR "TI
Issued -by: Dated Per'�t
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW F,E5ES
1ST FL. SO. FT. @ $
UNITS
COLL. AREA
2ND FL. SQ. FT. @
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. Ff.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SO. FT. @
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
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
GRADING
cu. yd.
$ plus x$
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SO.FT.GAR @ 3/ac
HOUSE SEWER
SPARK ARRESTOR
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 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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL