12823 (SFD)cei IOU
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P.O. BO
Building 44,-350 Villeta Drive78-105 CALL
Address LA QUINTA, CAL
Owner
Century* Homes -Communities
Hides
Mailing
Address 1535 South "D* Street., Ste. 200
City Zip Tel.
Sart Bernardino CA 92408 (509)-382--6007
Contractor
ress
ty jZip
State Lic. City
& Classif. 8 314473 Lic. # 2120
Arch., Engr.,
Designer Benjamin Aguilar & Assoc.
Address Tel.
5459 Passero Avenue (714)359-606
City Zip State
Riverside, -CA 92505 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapte 9 (commencing with Section
f 7000) of Division 3 of the Business and Professions -Code and my license is in full fnrne.anrl"-"
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Colitractor's License Law for the following
reason: (Sec. 7031.5,Business 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 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 penafty or 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 within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose or 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) 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 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compd'nsation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy Nom -C! Company
❑tt:opy is filed with the city. ❑ Certified copy is hereby furnished.
i
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 person in any manner so as to become subject to the Workers' Compensation
Laws of California.
r
Date Owner
NOTICE TO APPLICANT: If, after 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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 sof this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
X1504 No. 128:23
E ESTADO
IFORNIA 92253 i
JILDING: TYPE CONST. OCC: GRP.
P. Number 604-175'003
gal Description Lot 239 Tract .23269 Phase 7B
Project Description SFD Plan 5XL
La Quinta Del Rey
Sq. Ft. 2467
Size
New ❑ Add ❑
No.
Stories
No. Dw.
Units
Alter ❑ Repair ❑ Demolition ❑
'Estimated Valuation $136,144.00
PERMIT
Plan Chk. Dep. 250..
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
AMOUNT
TOTAL 1.4,959.16 1 4,709.16
REMAR
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 DA'
Issued by:
Validated
Validation
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
UNDERGROUND
A.C. UNIT
COLL. AREA
1ST FL. SQ. FT. @ $
UNITS
H PLUMB.
BONDING
HEATING (ROUGH)
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
SEWER
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. @
GAS (ROUGH)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. @
/
REINF. STEEL I/
s9S/
GAS (FINAL) /
DRAINAGE PIPING
CARP. SQ. FT. @
GROUT
WALL SO. FT. @
WATER HEATER
DRINKING FOUNTAIN
FINAL INSP.
URINAL
SQ. FT. @
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L 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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/a c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
FINAL INSPECTION- '
CERT. OCC.
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
PLUMBING '%}��l�i
[.�
UNDERGROUND
A.C. UNIT
COLL. AREA
�jROUGGROUND
SLAB GRADE — y—fes-1
1
H PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER
ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
/
REINF. STEEL I/
s9S/
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
(
J/ / ���
REMARKS:
11
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 2 g•
MESH
INSULATION/SOUND15 w
FINISH GRADING
FINAL INSPECTION- '
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL