15568 (SFD)4
P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Aririracc 44-330 OC®tillo Dri.Ve LA QUINTA, CALIFORNIA 92253
Owner Century Hames conmunities I
Mailing
Address 1535 South. OV Street,. Ste. 200
City Zip Tel.
San Bernardino CA 92408 (949)383-6007
Contractor
Sakme
Address
No. 25568
11LDING: TYPE CONST. NN OCC: GRP. R3
P- Number 604-4193--004
LOt 64 Tract 24517 Phase 3A
Iroject Description SF9 Plan 4
Rancho -Ocotillo
City
Zip
Tel.:
State Lic.
City
& Classif. 13 314473
Lic. # 2120
Sq. Ft. No. No. Dw.
Size 2436 Stories Units
Arch.; Engr., .P�'AWrz iza•JYi2i�i�.e s & Assoc.Designer
New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition,.❑
t1V,s East Chapman Avenue
01411359-6066
CitayState
l:iv rside, CA
Zip 92505
Lic. #
'
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor'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 o/ 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 live 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,
that such improvements are not Intended or offered /or sale. If. however, the building
or Improvement is sold within one year of completion, the owner -builder will have the burden
o/ proving that he did not build or knprove for the purpose o/ sale.)
Estimated Valuation$146,073.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. 664.75
COrlst. 304 O3
•
.
Mech. 49.00provided
• tii
Electrical 160.56
Plumbing 150.00
00
❑ 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 o/ property who builds or improves thereon, and who contracts for
such projects with a contractors) (lensed pursuant to the Contractor's License Law.)
11I am exempt under Sec- B. & P.C. for this reason
G
S.M.I. - 14.61
Grading 20.00
Driveway Enc. .00
Date Owner
Infrastructure 3,236.37
Arts •in Puha c Places. 115:1.€
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
O Copy Is filed with the city, 0 Certified copy is hereby furnished.
TOTAL 5,214.47
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.
Date_L' Owner
NOTICE TO APPLICANT: lt, 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.
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, -AND
Side Setback from Property Line
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.
Issuedby: Date
1 /` I'�(j
Validated by: t I fl I ^ 1 f
Signature of applicant Date
I
Mailing Address
Validation: + I -
I J U L 4 1=z) 1 r
Ry ��
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ, FT, ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
ROUGH PLUMB.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCTWORK
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.
SQ. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 V. c
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® 3/ac
HOUSE SEWER
WATER SYSTEM
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 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
JA
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER O f) NK
ROUGH WIRING
DUCTWORK
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. 01*13
FRAMING
FINAL INSP.
ROOFING Y, zjy-60
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUNffjfff 6V
FINISH GRADING
FINAL INSPECTIONM/3/ /�j
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL