07182 (MFD5)Building 78-309 Scarlet Court
Address
Owner
Boulevard Develomm
T a 0
d4f 4 4Q".
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 777 S. Main Street Suite 106
CityZip Tel.
Orange CA I92686- 714.547-8056
Contractor
Satire
Address
State Lic. I City
& Classjf.461814 Lic. #
Arch_; Engr.,
Designer
Address Tel.
City IZip I State
Lic. # 1
LICENSED CONTRACTOR'S DECLARATION f
I hereby affirm that 1 em licensed under provisions of Chapter.9 (commencing with Section
7000) of i n 3 of the Business and Professions Code, and/,,my license is in full force and
StGNATURE �v •:,4sv ..�" _f".. J DATE
OWNER-BIjILDER DECLARATION
1 hereby affirm than am exempt from the Contractor's License Law for the following
reasort (Sec. 7031.5,8asiress and RWessions Code: Any city or county which requires a
pem* to censbuct. alter, improve, demolish, or repair any structure, prior to its issuance also
requires Me applicant for such permit to fie a signed statement that he is licensed pursuant to
Me 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 Me alleged exerptim. Any violation of Section 7031.5 by 'any applicant for a permit
subjects Me appiirad to a uyvltpenally of not more than five hundred dollars (E500).
❑ 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 Cordractoes License Law does not apply to an owner of property who
bulls or improves thereon and who does such work himself or through his own employees,
Provided that such rrprovmnents are not intended or offered for safe. If, however, the building
or improvement is sold wiIhin one year of contolebon, the owner -builder will have the burden
of proving brat he did not build or improve for the purpose of sale.)
❑ 1, as owrmer of the property, am exclusively contracting with licensed contractors to con
-
project the project (Sec- 704 I. Business and Professtons Code: The Contractor's License Law
does not apply to an owner of property who toflds 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 -.
1 hereby affirm that 1 have a certificate of, consent to self -insure, -,or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company - - 11
❑ Copy is filed with the city. ❑ Certified copy ss hereby furnished.
v
Y
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(rhs section need not be comrplated ff 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 arty ppeerrssoon in any manner so as to become subject to the Workers' Compensation
Laws of Calitom"ia
Date .Owner
N0710E 7O APPLICANT: fl, after making this CerWicate of Exemption you should become
subject to the Rbdms' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this penrvt shag be deemed revoked.
CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency for the performance of the
wok for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders 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 certify that I have read this application and state that the above infgrnation is correct.
agree to comply with all city and county ordinances and state laws relating to building
or hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of
Mailing Adds
City, State,
No. 07182
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 613-790-013
Description OLD #27 Unit #259
t Description Plan 3U
Sq. Ft.
Size 763
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$56.886
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
2A9ff
Const.
Mech.
49 sin
Electrical
6Z. 7
Plumbing
94.51D
S.M.I.
3.99
Grading
Driveway Enc.
Infrastructure
1,279.34
A
TOTAL
s �ta..s •�
REMARKS
6�f1ct +61_ , te4_h .moi_ 4f�
3i: tvfla'rl � liittfl_ I c.t�s..,tr
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
2/2x/90
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
UNITS
SLAB GRADE � Q�
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOB]LEHOME SVC.
BAR SINK
POR. SQ. FT. ®
AS (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.
FT @
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. 0 q0/r
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/,c
HOUSE SEWER
FINISH GRADING
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 � Q�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 5— QL A
AS (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 q0/r
FRAMING 75 0 t�
/
FINAL INSP.
ROOFING
a�
S
10-b
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
1
LATHING / t� q O
MESH
j
INSULATION/SOUND �ho LD
t
FINISH GRADING
FINAL INSPECTION to (� G
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL