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07171 (MFD5)Building Address 76-223 Scar•1i�_,',Cour Owner Boulevard Development ' Mailing ._ Address 777 S. 'Mala - Street City Zip . Orange GA 92U6 Contractor Saiz Address ... P.O. BOX 1504 No. 78-105 CALLE ESTADO ' LA QUINTA, CALIFORNIA 92253 Sui to 106 rTi4547-8056 07171 BUILDING: TYPE CONST... OCC: GRP.- A.P. Number 613-790-072 Legal Description -60 #31 Unit #302 Project Description PIAn A City Zip Tel: ' State Lic. & Classif.461814 City Lic. # Sq. Ft. . gi2 No. No. Dw. Size • Stories Units - - ' Arch., Engr., New ❑ 'Add ❑ Alter ❑ Repair ❑ Demolition p ' Designer 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:".:� /'.� � .�-\�� .�,✓^�,. - SIGNATUREi' .X "` DATE OWNEWBuaDER 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 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 Division 3 or 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 subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). ❑ 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 or proving that he did not build or improve for the purpose of sale.) _ Estimated Valuation ¢ 2qC +�5 + 5 22J5 r' AMOUNT .PERMIT •- Plan Chk..Dep. Plan Chk. Bal: $ 316.23 CiOr1St . 486.50 Mach. , J' a a fit! Electrical -� - Plumbing - - - .. 112,50 - - ❑ 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.) •. ❑ I am exempt under Sec B. r'3 P.C. for this reason • S. M.I . • 4.62 - Grading Driveway Enc. Date Owner Infrastructure 1,467.57 WORKERS' COMPENSATION DECLARATION /f!'� 1hereby affirm that I have a certificate of consenffo self insure, •ora certificate ••. Worker's Compensation Insurance, or acertified;copy the reot,(Sec.�3800, Labor Code.) :Policy No. Company - rima - - - -. ' ❑ Copy is filed with the city. ❑ f� fled copy is hereby furnished ' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSUR ANCE TOTAL t9Zr fJ • 1_1 ., -__- oy�_J r -:d �^ REMARKS ' (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—, subject to the Workers' Compensation provisions of the Labor Code, you must forthwith .complywith such provisions or this permit shall be deemed revoked. - - - ZONE: BY: - - MinlmUm Setback Distances: , Front Setback from Center. Line • Rear Setback from Rear Prop. 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 Side Street Setback from Center Line • ` Side Setback from Property Line FINAL DATE INSPECTOR 4 �ry • Issued by: Date i 90 Permit , - Validated by: -- - 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 1130 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 iValidation: - -.' .`.« :. .y .T.. _: l• ,n -, .t- • City,. State,' Zip _ .rte- -- � _c CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE �j �0� ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SQ. FT. ® GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. BOND BEAM WATER SYSTEM URINAL SQ FT ® =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FRAMING 9o7 ( WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES REMARKS: WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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. SQ. FT. ® c BATH TUB MESH SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1Vi c SEWAGE DISPOSAL FINISH GRADING SQ.FT.GAR ® 3Ac 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 PLUMBIN L UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE �j �0� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. %� 2 QOr% 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. 3 U FRAMING 9o7 ( FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LA RING MESH INSULATIONISOUND 4 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL