10878 (BLCK)Building
Address 52-525 )ORRECON
Owner
JAMES SATTLEY
c&ty/-4 4 Qum&
P.O. BOX 1504
LA`Q&1
705 CALLE ESTADO
UINTA, CALIFORNIA 92253
Address 61-625 ECLECTIC
City Zip Tel.
BALM DESERT 92260 340-1361
Contractor
SAME
Address .
SAME
City ' , lZip Tel.:
No. 10878
LDING: TYPE CONST: OCC: GRP.
P. Number
Description
t n,-grrrinfinn 100' X 5' BLOCK WALL -
70' X 6' BLOCK WALL
State Lic.
City
B Classif. 248823
Lic. # 856
Sq- Ft.
No. No. Dw.
Size
Stories Units
' Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
7000) I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
• of Division 3 of the Business and'P,rofessions Code, and my license is in full force and
.effect: `.
,
' SIGNATURE r,.•� - r a� DATE
' OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
Estimated Valuation
$3,915
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a.
'permit
to construct, after, improve, demolish, or repafr•any structure, prior to its issuance also
regWres;the applicant. for such permit to rife 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 exempttherefrom, and the basis
for Any Section 7031.5 for
Plan Chk. Dep.
the alleged exemption. violation of by any applicant a permit
- subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). -
Plan Chk- Bala
-
❑ 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
Const..
$63 .00
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 0� employees,
provided that'such improvements. are not intended or.offered for sale. If, .holvev r, the building <
-
Mech.
or improvement is sold within one year Sf_completion, Ile owner -builder "n a v thelburde�
Electrical
of proving that he did not build or improv /6i the rpose of Va.)n/� � ��(�(/
O I, as owner of the properly, ar�/e�x�clusiv y c9 1w tensed contractors to.coo-
Plumbing
struct the project. (Sec. 7044, Bus'nes �f4ssiods Code:/7he Contractor's License Law
does not apply to an owner of proper4•iwhbbb builds or improves thereon, and who contracts for
S.M.I. -
"
:4'Vss��
s '
such projects. with a contractor(s) ficefis``ed pursuant to the Contractor's License Law.)
Grading
❑ Lam exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
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.).
��,A
Jt nla r ^r�C�`') a. ats
"POIiCy'No: �b t c!7/ .Company
Copy is filed with the city. ❑ Certified copy is hereby furnished..
TOTAL
•
CERTIFICATE OF EXEMPTION FROM
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, 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
Lenders 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 certity that l have read this application and state that the above informationis correct.
I'agree to comply with all city and county. ordinances and state laws relating to building
construction, and hereby authorize representatives -of this cityto enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS
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 Permit'
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEF
IST FL. SO. FT. ® $
UNITS
a
2ND FL. S0. FT.
YARD SPKLR SYSTEM
POR. S0. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
DUCT WORK
DRAINAGE PIPING
WALL S0. FT.
v
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
2 ayATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL _ FLOOR SUSPENDED
=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
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
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 .LIA
v
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM Q
2 ayATER SYSTEM
GRADING
cu. yd..
$ plus x$
=$
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
r'
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION•
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL