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15631 (GRES)r P.O. BOX 1504 Building47_35 Via Firenze LA QUINTA, CALIFORNIA 92 Addres 253 Owner Century Homes CG3i€IYi1'i. Shies Address .1535 South "DO St., Stee200 ILDING: TYPE CONST i. Number No. 1563. OCC: GRP. City an BibrnarT:-s ,* CA 92408 T(.909) 381=-6007 Legal Description Contractor Project Description Fr�ame/lat /` 123cCo single Safe car garage Address ty Zip I Tel.: State Lic. B 314473 (City 2120 & Classif. Lic. # Arch., Engr., 'Designer . Address I Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION /t y I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing wilhySeciion 1000) of Division 3 of the Bg iness and,,Professions Code, and,mv license is in full force and OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractors License Law for the following reason; (Sec.• 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, 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 penally of not more than live 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. 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.) ❑ 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) jicensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason Date Ownei WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company �. y 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 pornierson in any manner so as to become subject to the Workers' Compensation Laws of Califa Date Owner NOTICE TO APPLICANT: ff, 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.. ear a ac rom ear . rop Ine_ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND' °y�'��f Side Street Setbackfrom-Eentekine 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, Side Setback6from Property 4ine. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ I certify that I have read this application and state that the above information is correct. Issued by:_ 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. Validated by: Signature of applicant Date Estimated Valuation $400.00 Mailing Address PERMIT AMOUNT. Plan Chk. Dep. Plan Chk. Bal. Const. 30.00 Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure investfgatian fee 30. GO TOTAL 60.00 REMARKS Inyesticlation fee for startincf work without a oermit. ZONE: BY: Minimum Setback Distances'... Front Setback from Center Line R S tb k f R °P � ear a ac rom ear . rop Ine_ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND' °y�'��f Side Street Setbackfrom-Eentekine 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, Side Setback6from Property 4ine. 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. FINAL DATE 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. Issued by:_ 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. Validated by: Signature of applicant Date Mailing Address Validation:_ City, State, Zip Date CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN SO. FT. TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEMI 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 ® 1 V. c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER 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 I 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 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION TT y� d FIRE ZONE ROOFING FIREPLACE �S SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL t71VERTe,1Z 90Fa+M TEMv 3 TFrtP. 5. FItJ f L R. STLicc,oD J 9 �• GONG. S�� _ n I rymE-*rz of tlx�- - FCAV -010340'.. �AI.SE w�VER •1 )Of- fbY orNE-gS Jf-RW?4O ! ILLUMWATED ADDRESS MUAABERS TO BE CLEARLY VIS®LE FROM THE STREET. APPROI LA NING&Dc MENT DEPARTMENT BYDA i >r EX'H181 ��` 111 ;•��fa CASE NO - y ♦ y AN f. S oj C 1 tr r�1 c4 t F04. Fo