The URL can be used to link to this page

11511 (PLBG)y4. Building A ,IABuilding 52-760 OBRBGON 4P. O. BOX 1504 N o . 1151.1 .78-105 CALLE ESTADO �9 LA' TA, CALIFORNIA 92253 Owner RAUL SANTOS Mailing Address FAME City Zip Tel. 5 6 k— 36Ol4 LA QUIHTA 9225.51.3t0 -6t2-55&5 Contractor A.W.C. WNSTRUCTION Address 14136. BONNIE BEACH City Zip Tel.: LOS A]dGELES 9{2023 310-672-5383 State Lia City & Classif. ? c ; Lic. # Arch.,'Engr., '. Designer Address Tel. City I Zip 'IState Lic. # 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. :.• J I.:` f ' _SIGNATURE' DATE OWNER -BUILDER DECLARATION m I hereby affirm that I am exept.from the Contractor's License Law for the following reason: (Sec. 7031.5,Susiness 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 statementthathe_is licensedpursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Busiriess 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 rive hundred dollars.($500). ' 0 I, 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.) ❑ 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 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 Date Owner WORKERS' COMPENSATION DECLARATION 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. 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 ($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 lyaws of California. .(-Date Owner Ef' " ` •" NOTICE TO APPLICANT. If, after making' this Certificate `of Exemption you should become 'subject to' the Workers' Compensation 'provisions of the,..L•abor, 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 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 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description SEWER HOOKUP ZONE: Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation j .000, 000 - PERMIT AMOUNT Plan Chk. Dep.. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M:I. ' Grading Driveway Enc. Infrastructure TOTAL 15i.3 v• U EMARKS' 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 FEES IST FL. SQ. FT. $ UNITS COLL, AREA 2ND FL. SQ. FT. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ, FT. DUCT WORK DRAINAGE PIPING WALL SQ. FT. DRINKING FOUNTAIN. SQ 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE .UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ plus x$ LAUNDRYTRAY AIR HANDLING UNIT CFM KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY r 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. SQ. FT. RESID ® 1+A c SEWAGE DISPOSAL FIREPLACE SQ.FT.GAR ® Vec HOUSE SEWER SPARK ARRESTOR 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 SEWERUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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 i REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND 2 FINISH GRADING FINAL INSPECTION- p 2� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL COACHELLA VALLEY WATER+DISTRICT CASH RECEIPT!DETAIL ��.;,'��'(��-� -•�� \!:.tom \ ' Received From: ��• moi( ('''-�L'� Date -�� t '°J II ' •.(� Y`i i \i L7V'_i'� �. urF1 Address: 2�' s Account No. !l! L",:! (� '" L' ( Lot(s) Tract+ Service Address =� "I im :�. YE+. 1r, , " i• [t, t_.' }'}(`. G.A. Code' ❑ Meter(s) $ l 0 Service(s)' ' ❑ Backflow(s) ❑ House Lateral(s) ❑ Detector Check(s) x ❑Meter Surcharge a. fl//Sanitation Capacity Charge ❑ W.S.B.F.C. re„ ❑ Temporary Construction Meter ❑ Turn on Charge z ❑ Uncollected Account - Name ❑ Inspection Fee - Tract - Fee - a. ❑ Plan Check Fees Water / Sewer - Tract -. . ❑ Bond Payment - A.D. Bond Assmt. ❑ Customer Deposit ❑ Other . P• �_,. � .. TOTAL r, g Remarks: OCopy to r