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15154 (AR)P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address 47--935 via Firenze LA QUINTA, CALIFORNIA 92253 Century Howes Communities Address1535 South I'D" Street . City Zip Tel. San Bernardino 1 92408 (909) 381--6007 ContractorSameas above Address State Lic- City &.Glassif.:s �� Lic.# 2120 .Arch:, Engr:, - - Designer "'ia'An: Gonzales & Associates Address Tel. .. .. 336 East .C%epAan Ave (7.14) 532-6878 city.,Orange, CSI Zip 9066 State 9> Lic. # LICENSED CONTRACTOR'S DECLARATION E I heeby;affirm that•I'am licensed under provisions obChapter 9 (commencing with Section r 7000) of Division 3 of the Business and Professions -Code, and my license is in 1 11 force -and effect: OWNER-130ILDER DECLARATION I.hereby affirm that I am exempt from the Contractor's License Law for the following reason:- (Sec. 703 1. 5, Buslness�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 applican( 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 :he 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 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 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.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hehave a certificate of consent to self -insure, or a certificate of Worker's Zrmpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Poli�cy/No- Company GrCopy Is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE. (This {section need not be completed N the permit is for one hundred dollars ($100) valuation - or less.) ' I certify that in the performance of th0 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, ff, alter making this Certificate or Exemption you should become subject to the Workers' Compensation provisions or 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED- FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. _ This is a building permit when,prbperly filled out, signed and validated, and is subject to expiration if work thereunder is.silspended for 180 days. .. _ I certify that I have read this application and state that the. above information is correct. I agree to comply with all,city and county ordinances and state laws relating to building construction, and hereby authorize representatives. -of: this city .to enter the above-. mentioned property for•inspection purposes. Signature of applicant Date ,.Mailing Address City, State, Zip No. 15154 BUILDING: TYPE CONST. - OCC: GRP. • A.P. Number Legal Description Supp eme+nta1 Permit for Project Description PermitX1435: Admit cnai Living -Space. fat enlarger Guest Room (3B) Sq. Ft. � • '• No. No. Dw.. Size. '- Stories Units " New ❑ 'Add 0''. Alter ❑ Repair O Demolition ❑ Front Setback from Center Line Rear -Setback from, Rear Prop. Line - Side Street Setback from Center Line' Side Setback from Property Line ' FINAL DATE INSPECTOR Issued by: - Date <er�}t Validated by: Estimated Valuation, •$-3o539.00 :y PERMI1T Validation: AMOUNT Plan Chk. Dep: Plan Chk. Bal. Const. 10150 Mech. 0 Electrical 1,53 Plumbing 0- _S.M-I. S.M.I. ._ 6 Grading 0 Driveway Enc., ` Q Infrastructure- $79-.63 ADE-7—n-PUBT-1—c P Iacea TOTAL 51$3.77 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 <er�}t Validated by: Validation: n4 V 1 • 1. - - P 1 CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW;'FE1Z-- 1ST FL. SQ. FT. @ $ UNITS 2ND FL. SQ. FT. p SLAB GRADE YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. DRAINAGE PIPING WALL SO. FT. DRINKING FOUNTAIN SO. FT. ® GAS (ROUGH) URINAL ESTIMATED CONSTRUCTION VALUATION $ HEATING (FINAL) 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL . FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM WATER SYSTEM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c- WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/e c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FIREPLACE GAS PIPING PERMIT FEE SPARK ARRESTOR 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 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. FRAMING v FINAL INSP. ROOFING ,T E REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND ^� FINISH GRADING FINAL INSPECTION $ �� CERT. OCC. FENCE FINAL 7 INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL