13410 (BLCK)Buildina
Address 51-390 AVENIDA
Owner
MR. ROGER MEIER
Mailing
Address SAME
City I zip
LA QUIMA 92253
Contractor
TAt
KI 12M n
P.O. BOX 1504 U
78-105 CALLE ESTADO
9GON LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC GRP.-
A.P. Number
Tel. 328-3480 Legal Description
Project Description 521f of 21 retaining
A with a 4` garden wall on tou and
Aaaress
54-370 AVENIDA OBREGON
City LA QUINTA 7 p 92253
State Lic.
& Classif. C 381851
Arch., Engr.,
Designer
Address
Tel.
564-2935
City
Lic. # A;
Tel.
City Zip State
I I Lic. #
LICENSED CONTRACTOR'S DECLARATION
I herebgffirm that Ijim licensed under provisions of Chapter 9 (commencing with Section
7000) of ivision 3rof,,he Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWN,ER-BUILDER 6ECLARATION
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 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).
0 1, 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.)
0 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 to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractorts) 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
0 Copy is filed with the city. 0 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 (S100) valuation
or less.)
I certify that in the performance of thp 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 Addres
This is a builclin� permit when properly filled out, signed and validated, and is subject -to
expiration it work I e reunder is suspended for 180 days.
, I car tify 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, Zi
4i
7701f of 21
retaining
wall
Sq. Ft.
Size
No.
Stories
No. Dw.
Units
New 0 Add 0 Alter 0
Repair 0 Demolition
Estimated Valuation
$1300.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const!
Mech.
Electrical
Plumbing
S. M. 1.
Grading
Driveway Enc.
Infrastructure
TOTAL
$45.00
REMARKS
ZONE: —BY:
Minimum Setback Distances:
Front Setback from Center Lin
Rear Setback f r 6M Rear Prop. Line
Side Street Set back,f ro—mCenter-Li ne
—Side Setback fromiPT" pert 'N\ Q
FINAL DATE —INSPECTXP,
Issued by: —Date I; pjrT$ 1.qQA
Validated by: V I
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FFES
$
UNITS
COLL. AREA
1ST FL. SO. FT. @
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
GAS(ROUGH)
METER LOOP
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. @
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. @
WATER HEATER
WALL SQ. FT. @
FINAL INSP.
DRINKING FOUNTAIN.
BONDBEAM
URINAL
SQ. FT. @
GRADING
cu. yd.
s—plus—x$—=$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM- FAN EVAP.COOL HOOD
SIGN''
WASH ER(AUTO)(DI SH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SO. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
INSULATIONISOUND
SQ.FT.GAR @ 3/4c
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBIL
TOTAL FEES
MICRO FEE
MECH.FEE EPL.CK.FEE -r3N�
ELECT.FEE
SMIFEE 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. REIN
GAS(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BONDBEAM
WATER SYSTEM
GRADING
cu. yd.
s—plus—x$—=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
I
ROOFING
el
Ll S --g
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTIW—
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL