Loading...
002615 (BLCK)P.O. BOX 1504 N O. 002615 Building 78-105 CALLE ESTADO Address 524-51 a LA QUINTA, CALIFORNIA 92253 Owner Had31Qi BUILDING: TYPE CONST. OCC: GRP. Mailing Address A.P. Number %i3-28�� CityZip Tel. Legal Description rot 1 au ho Contractor Project Description Address. City Zip Tela State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New R_� Add ❑ Alter ❑- Repair ❑ Demolition ❑ Address Tel. City Zip State 152 IL -a. €t. 3- .O retaining o� 2.04 i1n. f. of S00t hic*I'mmid fenM _ 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 OWNER -BUILDER DECLARATIONEstimated Valuation +{ n I hereby affirm that I am exempt from .the Contractor's License Law for the following" A.L4'a i7 reason: (Sec. 7031.5,Business and Professions Code: Any city or county 'which requires a r 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 PERMIT AMOUNT 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 Plan Chk. Dep. subjects the applicant to a -civil penalty ofnot more thanfivehundred dollars ($500). • ti2 3 ❑ I, as owner of the. property, or my employees with wages as their sole compensation, will Plan Chk. Bal 32.8 do.the work, and the structure is not intended or offered for.sale. (Sec. 7044, Buisness and Const.. W.50 builds Code: The Contractor's License Law does not,apply,to an owner of property whoo- builds or improves thereon and who does such work 'himself or through .his own employees, Mech.- . _ 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. Electrical of proving that he did not build or improve for the.purpose of sale.)'- ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con Plumbing 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.) ❑ I am exempt under Sec. B. 8 P.C. for this reason Grading Driveway Enc. Date Owner '4 F Infrastructure 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL 93.82 CERTIFICATE OF EXEMPTION FROM REMARKS . - 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 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 ZONE: BY:' subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: - comply with such provisions or this permit shall be deemed revoked. Front Setback from Center Line 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 Mailing Address City, State, Zip HARD COPY Rear Setback from, Rear Prop. Line_ Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date " 'SPermit Validated by: Validation. A6568 1. U. 22 83,82 CK CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT 2ND FL. SO. FT. SLAB GRADE YARD SPKLR SYSTEM FOR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT, ® POWER OUTLET I ROOF DRAINS CAR P. SO. FT. ROUGH WIRING DRAINAGE PIPING WALL SO. FT. DUCT WORK DRINKING FOUNTAIN SO FT ® GAS (ROUGH) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation REINF. STEEL FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER SERVICE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM WATER SYSTEM 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL FIREPLACE SO.FT.GAR ® 3Ac HOUSE SEWER LATHING MESH INSULATIONISOUND GAS PIPING PERMIT FEE CERT. OCC. 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 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK GS �� SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUN .REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE G OUT WATER HEATER SERVICE FINAL INSP. D BEAM �/ �B WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING DEC REMARKS: 17(�7 VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDtN WALL FINAL..