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12824 (SFD)4 P.O. BOX 1504 No. 12824 Building 44-360 Villeta Drive 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner centary Homes Commun ities Mailing BUILDING: TYPE CONST. OCC: GRP. Address 1535 South "D" Street, Ste. 200 A.P. Number 609-175-002 City zip Tel. Lot 240 Tract 23269 Phase 78 $a!1 Bernardino CA 92408 1(909)381-6007 Legal Description ContractorSFD Plan 4X Project Description Sante La Quinta Del Rey Address Zip State Lic..71 City 3�� & Classif. Lic. # 3120 Arch., Engr., Designer Benjamin in itgu filar 6 ASSOC. 5 d5e9SsPassero Avenue 1714) 359. 6066 CityZip/ State Riversides £A 92505 Lic.# LICENSED CONTRACTOR'S DECLARATION I hereby affiimthat I am li 7000) censed under provisions of Chapter•9':(commen with Section of.Division 3 of the Business and Professions.Code, and -my license is in full force and \PfecL"y- �' OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from-therC n actor's 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 penalty of 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 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 hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No---- Company L,Copy 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., If, 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. 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 of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip 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 frQaProperty Line FINAL, DATE 1ArJAPFQ Issued by: DaF,,mN,4 'r Validated by: R , Validation: Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $102,819..00 PERMIT AMOUNT Plan Chk. Dep. 250.00 Plan Chk. Bal. 304.49 Const. 650.00 Mech. _ 55.50 Electrical 135445 Plumbing 168.00 S.M.I. 10.25 Grading 20.00 Driveway Enc. .0 . Infrastructure 2,313.43' rtes in Public Places 25.W TOTAL 3,932.15 3,652.15 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 frQaProperty Line FINAL, DATE 1ArJAPFQ Issued by: DaF,,mN,4 'r Validated by: R , Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE �(� ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ FORMS SEWER ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. p GAS (ROUGH 11 1 VL METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® GAS (FINAL g TEMP. POLE GROUT DRAINAGE PIPING CAR P. SD. FT. @ FINAL INSP. WALL SQ. FT. ® DRINKING FOUNTAIN GRADING cu. yd. $ —Plus—x$—=$ URINAL SQ FT ® FRAMING Q FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING' — NOTE: Not to be used as property tax valuation REMARKS: 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 SPARK ARRESTOR 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FENCE FINAL GAS PIPING PERMIT FEE INSPECTOR'S SIGNATURES/INITIALS PERMIT FEE PERMIT FEE DBL, TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE 19PLUMBING l/ ELECTRICAL HEATING & AIR COND. SOLAR 1 SETBACK GROUND PLUMBIN lC. 'l UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE �(� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH 11 1 VL METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL g TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ —Plus—x$—=$ LUMBER GR. FINAL INSP.1 094 FRAMING Q FINAL INSP. ROOFING �� q,Lef o1(/ j S/Z7 REMARKS: VENTILATION FIRE ZONE ROOFINGl� FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHINGFly MESH INSULATIONISOUND 9 FINISH GRADING FINAL INSPECTION i CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 7 r4 r, P .�V k Wu*nt 11 U 0 in a n b'- •t thtston This Certificate issued pursuant to the requirements qu ments of Section 306 of the, Uniform'Building! 'Code certifying that at the time of issuance this structure was In compliance with the various 7 t, ordinances of the City regulating building construction or use. For the following: t6 yiiielt&.. Drive 44r3 60� BUILDING .'ADDRESS &qelling- Bldg. Permit No. -- Use Clatelficotion Single Family 12824'- %41 Firelone R3 Group Type Construction VM Use Zone SR `Owner of* Building j t; I Address 1535 gojjth linil Street, ste- 900 city San Bernardino, CA 92408 By Bruce ler -411- Date; July 20, 1994 j Building Official 4t PLACE