15155 (AR)T .. r ..
• T • u • • e `^ Tlihf 44
•x`+T
P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 47-995. Via Firenze LA QUINTA, CALIFORNIA 92253.
Owner Century ppi' a comunities
Mailing
Address2535 South litD91 Street
City lZip Tel.
San Bernardino .92468 909) 381-6047
Contractor
Same as above
Address
p
State Lic. B 314473 (City 2220
& Classif. _ Lic. #
Arcn., Lngr:,
Designer Frank (Jonzales & Associates .
AdJ 36 .East 1 2 a_p nra Awe Tel.
i4) 532-6878
City Zip State
f3�. 9266f5 Lic #
,�,..r LICENSED CONTRACTOR S DECL'dRATION ' '
nP hereby affirm,;tfiat I am licensed under provisions of ch pier 9 (comm<
r 7000) of Division 3 of the Business and Professions=Code, and my licenst
•effect. .•"' !: " ,.
with Section•
full •force and"'
;T__ OWNER -BUILDER DECLARATION
I hereby affirm that I am
,eiiempt from the Contractors License Law for the: following
reason: (Sec.. 703 1.,5, Business and Professions Code:. Any city or county which requires a -
permlt to construct, atter, 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
Me
provisions of the Contractor's license Law, Chapter 9 (commencing with Section 7000) of
Division 3 or 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 rove hundred dollars ($500).
O 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
I or improvement is sold within one year of completion, the owner -builder will have the burden
of rovin that he did not build or ' rove for the u ose of sale )
No. 15155.
BUILDING: TYPE CONST.. OCC: GRP.
A.P. Number
Legal Description
Project Description eSi3,Jt] lemdntal Permit fOr
-Permit 0.14947 (3AR) Additional tiva.ng
Space at Enlarged Guest Room
Sq. Ft. 102 No.
Size Stories
New ❑ Add ❑ Alter ❑
Estimated Valuation, X3'0539.00
PERMIT
.Plan Chk. Dep. .
Plan Chk. Bal.
Const
Mech.
Electrical
No. Dw.
Units
Repair ❑ :.Demolition ❑
SID.
P 9 �P PrP
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
' 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) Ucensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B.•& P.C. for this reason
$. M.I. -_
• '
Grading
Driveway Enc.
€�
Date Owner
Infrastructure'
'� •
ArE In- _&
1C Places ts.• :3
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
WorkeP29mpensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Company
Copy is filed with the city, O Certified copyis hereby furnished.
TOTAL
*1 U6•I l
. CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE'
REMARKS
'
(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
Dite Owner.
NOTICE TO APPLICANT. N, affer 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. s
ZONE: BY: '
- -
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
Side Street Setback from Center Line '
HUNDRED THOUSAND DOLLARS ($11X)•000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback from Property Line
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.
FINAL DATE
INSPECTOR
_ 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.
-issued by- '
: ..
Validated by:
Date `-Pefnli
a U
Signature of applicant —Date—.j
Mailing Address
Validation,
AA A V 1 7 1QQ t
•V,
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. ' PLUMBIW FEES„
1ST FL. SQ. FT. ® $
UNITS
------------
I `
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CARP. SQ. FT.
OTHER APP.IEOUIP.
REINF. STEEL
WALL SQ. FT.
TEMP. POLE
DRINKING FOUNTAIN
SQ. FT. ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
_$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SPARK ARRESTOR
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE JPL.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
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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 SIONATURESIINITIALS
GARDEN WALL FINAL 7d