002279 (SATT)Building
Address 54-745 Oak Hill
Owner
a1Rw
Mailing
Address 75-005 OMmifty
City C lZip
Contractor
Tel.
Aaaress.
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City
sare
Zip
Tela
State Lic.
City
& Classif. 2 5 3
Lic. #
.Arch., Engr., .
Designer
Address
Tel.
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ot
P.O. BOX 1504 No. 002249
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
a2= Legal.Description
Project Description MAI ami' PM 3 OR
3A
162
Sq. Ft. (-1 4d4 No. Y No. Dw. 1
Size Stories Units -
New ❑Add ❑ Alter ❑ Repair ❑ Demolition O
City Zip State
....... .. .. Lic. #
LICENSED CONTRACTOR'S DECLARATION ..
hereb' affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70 00) of Division 3 of+the Business and Professions. Code, and my'license is in full force and '
at act
SIGNATURE i 6 N "' lA:^-"�-+"'�14" a 'DATE
OWNER -BUILDER DECLARATION
I hereby affi m that I am exempt from1the Contractor's. License Law for the following Estimated Valuation
reason: (Sec. 70'31. 5, Business and Professions Code: Any. city or county. which requires a
lie q116%r3r"
'
PERMIT,,
permit to construct, alter, impiove, 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, bi thathe is' exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
-
Plan Chk. . Dep.
subjects'the applicant to a civil penalty of not more than five hundred dollars ($500). -
. O I, as owner of the. property, or my employees with wages as their'sole, compensation, will
- -
Plan Chk. Bal..
COnSt.
'
do the work, and the structure is not intended or offered for sale. (Seca 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner. of property who
Mech.
builds or improves thereon and who does such work himself or through his own employees,
providetl that' such improvements are not intended or offered for sale. If, however, the building
Electrical -
- 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.) -
Plumbing
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
S.M.I.
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
Grading
Driveway Enc.
4 1U 255876 CK
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent 4o self -insure, or'a certificate 'of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
0 Copy is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
q 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.
Date . ' Owner
NOTICE TO APPLICANT: If, alter 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 ttrat 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 inspectiontp%
urposes. y f n
Signature of applicant
�. J 1fr_ 1.%f�f>. r Date
Mailing Address r *`
City, State, Zip V
f
HARD COPY
TOTAL
REMARKS
AMOUNT
364.19
9
443.50
34.00
67.41
8-7.50
TAS
1,554.98
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 DATE
INSPECTOR
Issued by:
Date 4-10-8fPermit
Validated by:
Validation:
A5186
4 1U 255876 CK
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEEP '
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
v
i GAS (ROUGH) /
/
DRAINAGE PIPING
WALL SQ. FT. ®
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1114 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
LATHING
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
9445 BACK
Yv��_��6/0
9163ROUND PLUMBING�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. ', 46l Y.
/ ,N% ,F
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS L/
OSEWER OR SEPT
V
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
v
i GAS (ROUGH) /
/
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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.
24 FRAMING 7O C
FINAL INSP.
�CROOFING -7 �
/ � r
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL