07187 (MFD5)Building
Address 7&287 Scarlet Court
Owner
Boulevard tlevelomm
T4-',�t 4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailin
Address 777 S. stain Street Suite 1€6
City Zip Tel.
Orange CA . 12686 714.547-•8055'
Contractor
Same
State Lic. I City
& Classif. 461814 Lic. #
Arch., Engr.,
Designer
Address I Tel.
City IZip I State I
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 " `A-1
SIGNATURE r r'--+' "' - DATE
GrOWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busiress and Professions Code: Any city or county which requires a
permit to construct, after, brprove, 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 Contractors 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 'any applicant for a permit
subjects the applicant to a ci illpenahy of not more than five hundred dollars ($500).
❑ 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
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or knproves 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 orerprove for the purpose of safe.)
❑ 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_ w, & P.C. for this reason
Date Owner
i
WORKERS' COMPENSATION DECLARATION f
1 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 Co e.)
Policy No. ComPa�y - "'�
❑ Copy is filed with the city. ❑ Certified copyis hereby` furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of lhp 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: ff, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith
comply with such provisions or this pemtit 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 property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity 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
No. 07187
JILDING: • TYPE CONST. OCC: GRP
P. Number 613-790-013
Description
Description
OLD #28 Unit #270
Plan X
Sq. Ft.733 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $561886
PERMIT
AMOUNT
Plan Chk.'Dep.
Plan Chk. Bal.
d -.
Const.
.UU
Mech.
49. bU
Electrical
U-161
Plumbing
94,
S.M.I.,
Grading
Driveway Enc.
Infrastructure
1,L779,94
TOTAL
REMARKS ;Y'1r,4"�. tlrh iXtvar+�dtA-�t3i�ar,r tet^ lli
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 2/21/90Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. (& $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE 1
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF. 7� 4
�1
DRAINAGE PIPING
CAR P. SQ. FT. ®
HEATING (FINAL)
WALL SQ. FT.
REINF. STEEL
DRINKING FOUNTAIN.
GAS (FINAL)
TEMP. POLE
URINAL
SQ FT ®
GROUT
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FRAMING 7/3 0 //
'/
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/ic
HOUSE SEWER
GAR. FIREWALL
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 ®?eT
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 1
�% lj
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 7� 4
�1
of 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. 0
FRAMING 7/3 0 //
'/
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA ING `C 0 L_
MESH
INSULATION/SOUND-?/1/16 L
FINISH GRADING
FINAL INSPECTION D
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
'
GARDEN WALL FINAL