002571 (SATT)Building
55-900 Mviera
Address
SIGNATURE J DATE
Owner
OWNER -BUILDER DECLARATION
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-
Estimated Valuation
- H' 6
_ ..
PERMIT -
Mailing
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Address.
75-005 t T Orb DZ
City
2
Zip
Contractor
Y`_L-Atll Vim.
Address
City Zip Tel..
I P.O. BOX 1504
# 78-105 CALLE ESTADO
LA.QUINTA,.CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.'
A.P. Number
Legal Description
Project Description PM TM PIRM 3 C
PUA 300 M
State Lic. City MG 3971
& Classif. 288Lic. # 32$' Sq. Ft. No. No. Dw.
Size " - 6�'� Stories Units
..Arch.; Engr.; .. ..
Designer New ❑x Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
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. � , .
SIGNATURE J DATE
ZONE:
OWNER -BUILDER DECLARATION
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-
Estimated Valuation
- H' 6
_ ..
PERMIT -
_ 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
Rear Setback from Rear Prop. Line
-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, of not more than five hundred dollars ($500).' .
❑ I,as owner of the property, or my.employees with wages as their sole compensation, will
. Plan .Chk. Bal.
Const. -
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
Mech.
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
Electrical -
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 or sale.) _
Plumbing -
O 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 or property who builds or improves" thereon; and who contracts for
-
S•M•I: -
- such projects with a contractors) licensed pursuant to the Contractor's License Law.) -
0.I am exempt under. Sec. B. & P.C. for this reason -
Grading
Driveway Enc.
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
O Copy is filed with the city. . O Certified copy is,hereby.furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit 4s 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_L- ' Owner
NOTICE TO APPLICANT: If, after making this Certificate. or Exemption you should become
' subject to •'the Workers' Compensation provisions or '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 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., -.a
Signature of applicant�` `.�%r.. *��v•.. Date
Mailing Address t '' .y �` 'K -
City, State, Zip ° L
Or
HARD COPY
,01844.00' .
AMOUNT
Infrastructure 2,000.00
TOTAL
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 9-10 46Permit
Validated by-,
Validation:
A 6 3 1 6
9 10 X85548 R
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES:
NO. PLUMBING FEES
1ST FL. SO. FT. .@ $
UNITS
SLAB GRADE
2ND FL. SO. FT. ®
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®_
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. ®
OTHER APP.IEOUIP.
DRINKINGFOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER HEATER
SERVICE
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
GRADING
cu. yd.
$, plus x$
_$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
FRAMING
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH) ,
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT . WALL FLOOR . SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a 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.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC..
FENCE FINAL.
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL