001948 (ELEC)Building
Address 54-110 Oak Tme
Owner
Mailing
Address a5 CbarrtrV
City Zip
Contractor
Address....
Sam
State Lic.
& Classif.
' Arch., Engr.,
Designer
P.O. BOX 1504 NO. V l S it 8
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
1kiw A.P. Number
Tel.
568-2828 Legal. Description
Project Description VEST
Sam
City
Lic. #
Sq. Ft.
Size -
New Q
No. No. Dw.
Stories Units
Add ❑ Alter ❑ . Repair ❑
Address Tel.
City Zip State
Lic. #
.T -amypowwpa%
. LICENSED CONTRACTOR'S.DECLARATION .
I hereby at
affirm th.l am'licensed under provisions of Chapter -9 (commencing with Section
7000) of Division.3'oflfhe Business and Professions, Code, and.my license is in full force and-".
effectV �!
o�r
SIGNATURE '"\ 1' DATE
' OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from/he Contractor's License Law fouthe following
reason: (Sec. 7031.S,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 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.) - -
❑ I, as owner of the properly, 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.)'
O 1 am. exempt under Sec. B. & P.C. for this reason
Estimated _Valuation ..�..
'
PER
Plan Chk. Dep. .
Plan Chk. 8a1.
const..
Mech.
Electrical '
Plumbing
S. M. 1. -
Grading
Driveway Enc.
Date owner
Infrastructure
comply with such provisions or this permit shall be deemed revoked.
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. ❑ 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
-
Front.Setback from Center. Line
TOTAL
REMARKS
'
Demolition ❑
AMOUNT -
2 .
MOUNT -2x3. G0
20.00
or ss.)
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 subjectito the Workers' Compensation
Laws of California.
Date__!Owner
NOTICE TO APPLICANT: If, after making this Certificate of!Exemption'you should become.;
ZONE:
BY:
subject' to the Workers' Compensation provisions of the Labor Code, you 'must 'forthwith
Minimum Setback
DlStahCBS:
comply with such provisions or this permit shall be deemed revoked.
_'
Front.Setback from Center. Line
Rear Setback from Rear Prop..Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.) - -
Side Setback from Property Line.
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
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.
-Issued by:
Date Permit
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-. j
mentioned property for inspection%purposes.°
Validated by:
'/ ✓
Signature of applican'Date::...-
,..rw
_
Mailing Address
Validation:
City, State, Zip r.
,
A3551
12 11
t0. 0'Q CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. 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
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBLTAL
TOFEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL 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 SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
.FENCE FINAL
1145MUiVn's WUNAiuneWmiIIALs.
GARDEN WALL FINAL