003463 (ELEC)Building
Address 55-905 Riviera
Owner
Palmer Cormm�n �s~a
Mailing
Address 41-725 Cook Sere,
City Zip
Palm Desert 92264
Contractor
Address
City..... Zip
P.O. BOX 1504 NO. 003463
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
1`£° Xnc" BUILDING:. TYPE CONST. ' -OCC: GRP.
p. 0.. Box 368 A.P. Number PGA ti'iest
Tel.
340 -1312 - Legal Description
Project Description _300 Amp Meter Pedestal
Tel.
State Lic.
City
& Classif.
Lic. #
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.DECLAEiATION
'
I hereby affirm that I am licensed under provisions of Chapter,9 (commencing with Section
7000) of Division 3 of tth•_e,Business;and Professions Code, and my licenswis in full force and .
�S
effect. 7—
SIGNATURE - _.._^"" DATE
' OWNER -BUILDER DECLARATION'
I hereby affirm that I am exempt from the Contractor's• License Law for the following
Estimated Valuation
reason: (Sec, 7031.•5,Business and Professions Code: Any city or county which requires a
-
- PERMIT. -
--•
AMOUNT -
permit to construct, alter, improve, demolish, or repair any -structure, prior to its issuance also
requires the applicant for such permit to file asigned 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 'anyapplicant for a permit
-'subjects the applicant to a civil penalty of not more than live hundred dollars'.($500):-
O I, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Dep.
-
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_
f1l (in
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.) . . ., . .9
Plumbing
❑ I, as owner of the properly, am exclusively contracting with licensed contractors to con-
strucl 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. 1. -
_.
-
such projects with a contractor(s) licensed pursuant to the Contractor'sLicense Law.)
O, 1 a exempt under Sec... B. 8 P.C. for this reason -
Grading
-
Driveway Enc.
-
Date' Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate'of consent to'self-insure,-or a certificate of
_
Worker'sCompensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) '
'Policy No. Company
0 Copy is.filed with the city. . ❑ Certified copy is hereby furnished.
TOTAL
Vii# Ata
REMARKS.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
1'k+1: ' R +:tom 6 tS - '�; �'1 A: i /ti
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
• I certifythatin 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
'subject to the' Workers' Compensation provisions 'of the Labor Code,` you must forthwith'
comply with such provisions or this permit shall be deemed revoked.
ZONE: - BY:
Minimum Setback Distances:
Front Setback from.Center. Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
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.)
Side Street Setback from Center Line
Side -Setback from Property Line.
Lender's Name '
FINAL DATE
Issued by::
Valldated.by:
INSPECTOR
Date
Lender's Address
' This is a building permit when properly filled but, signed and validated, and is subject to '
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct:
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
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT. ®
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. _ SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT. ®
GAS (ROUGH)
DRINKING FOUNTAIN
SQ. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
TEMP. POLE
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
SERVICE
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:
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.
SQ. FT. RESID ® 11/a c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE id
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 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. �v Z >
/
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