12844 (SFD)l t!'�G`GiCu
P.O. BOX 1504
Building 44-460: Villeta Drive 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Century. Homes Communities
Addr'es's 1535 South s+Da Street, Ste. 200
CityZip ' Tel.
San Bernardino CA 92408 (90911381-6007
Contractor
Same
Address
City
Zip I Tel.
State Lic. B 314473 IGity 2120
& Classif. Lic. #
Des nergr laenj'amin AC ai"ar & Assoc.
9
.,Addres l.
P.assero Avenue Te(719) 359-6066
i
City Zip State
Fi�.ver9ide,--'CA 1 92505 Lic. #__
LICENSED CONTRACTOR'S.DECLARATION
I hereby affirm that I am licensed under grovisions tjf Chapter9 (coking with Section
000) of f tt
Division 3 oheei ine„s and.PiofessipnssCode,7and my license is in full force and
jOWNER-BUILDER DECLARATION
I hereby affirm that I 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 penalry 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
orimprovement 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.)
O 1, 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 town owner of property who builds or improves thereon, and who contracts for
such projects, with a contractors) licensed pursuant to the Contractor's License Law.)
0 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�,kopy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be complered 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 if 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 Al
Mailing Address
City, State, Zip
No.
11LDING: TYPE CONST. OCC: GRP.
P. Number 604-175-006
12844
T�n+- 1 A A T�T+� t•� 9 7 C�, LIP% n c r% ` i%
Legal Description
Project Description A SPI) Plan 5V
La Quinta Del Ray
Sq. Ft. 2010 No. No. Dw.
Size Stories • Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation,1It`Q56.00
BY:
PERMIT
.%P A
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
329.44
Const.
692.00'
Mech. -.
49..40
Electrical
141.63
Plumbing
144,•00
S.M.I.
11.50
Grading
20.00
Driveway Enc.
00
Infrastructure
2,528.06
Arts in Pubi'i c Places.
35.15
TOTAL 4,199.78
3,949.78
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
k q
FINAL DATE
INSPEC4Pe
-'Validated
Issued by:
Date
by:Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEESA
1ST FL. SO. FT. ® $
UNITS
_
n f•
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
�
GAS (ROUGH)_
METER LOOP
DRAINAGE PIPING
CAR P. SO. FT. ®
REINF. STEEL
I
WALL -SO. FT.®
TEMP. POLE
DRINKING FOUNTAIN
URINAL
SO. FT. ®
WATER HEATER
SERVICE
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING (
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
n
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
LATHING C
rl
MESH
SQ.FT.GAR ® 3/nc
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 PLUMBING '�EL��AL 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
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 3 •
�
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
O� ,, ,n
40
J (((
n
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING C
rl
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
.41
11P
S.,
,XOF
`U ut
'4 -vl
Illi I .a �,.� � 3�.� r�
bin a, -Sget�� tiltstOn"
J�r
rW
-Certificate issued pursuant to the requ
-This ii�ements of -Section 306 of the, Uiii&A"��Bu'ildini
Code certifying that at the time of issuance this structure was In compliance with the various.
ordinances of the City regulating building construction or use. For the following.
i6101h6i"ADDREts �x-,4 4 -j-4 60 .yi lieta Drive,,,,,.
UseClossificition, Single :Family Dwelling Bldg. Permit: No.
la 'e
1
" 1
Zone R3 TypeVN Or* Wi Use —
Construction
Group
Hnrnip q rn `60drsss 1 SA .Snaith T) Rj-rt&Pj- P St -P_ NMI
Owner of Building Century
City o,
San Bernardino; CA 92408
Bi Rrtir_,P_ PP -1 I P -f i Pr
Q'XJuly-8, 1994
,' Date.
Building Official V;*'.
-'00WO"CUOUS PLiti
P'M f N"- A"
I