07152 (MFD5)Building
Address 78-315 Scarlet Court
Owner
T4.t!t 4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address 777 S. Hain Street Suite 1.06
City Zip Tel.
Orme CA 1 9.26851.714-547-8056
Same
Tela
State Lic. City
& Classif.46l814 Lic. #
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70pD) CLD
f Dion 3 of the Business and Professions Code, and my licerise is in full force and
effects.:,.
SIGNATURE DATE
�/ OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5.Busress and Professions Code: Any city or county which requires a
pem* 10 construct, alter, reprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Irle a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Uvfsion 3 of the Business and Profession Code, or that. he is exempt therefrom, and the basis
for the afted exemption. Any vitiation of Section 7031.5 by 'any applicant for a permit
subjects the appfrant to a clivi penalty of not more than five hundred dollars ($500).
❑ 1, as owner of the properly, 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, Suisness and
Professions Code. The Contractor's License Law does not apply to an owner of property who
Ix ilds or improves thereon and who does such work himself or through his own employees,
provided that such krpmvene is are not Wended or offered for sale. If, however, the building
or erproverme t is sold wWd one year of completion, the owner -builder will have the burden
ofproving that he did not cif or inprove for the purpose of sale.)
❑ 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 burTds or improves thereon, and who contracts for
such projects with a conbactor(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 I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, ova certified,
thereof. (Sec. 3800, Labor Code.)
Policy No Company- -" 'fit- , ••
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
a
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
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-- tl, after making this Certificate of Exemption you should become
subject to the Wbrkeas' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shag be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, CW Code.)
Lenders Name
Lenders 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.
1 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
Maihing.Addrrss
City, State, Zip
No.
11LDING: TYPE CONST. OCC: GRP.
P. Number 613-790-013
07152
Description BLD #27 Unit #256
t Description Plan 2L
Sq. Ft. 912
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
42Ij�
�r
$65.
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
316.23
Const.
486.50
Mech.
54.00
Electrical
67.14
Plumbing
112.50
S.M.I.
4.62
Grading
Driveway Enc.
Infrastructure
1,467.57
TOTAL
$2,508.56
REMARKS
_.
�tr.l l- Sf13L�j1] C �I�7Fi_. ,���•4_7 i)J. �L�r "r
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 2/21/90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
k0. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE S
YARD SPKLR SYSTEM
2ND FL SO. FT. @
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF. /
J
DRAINAGE PIPING
CAR P. SO. FT. ®
HEATING (FINAL)
WALL SO. FT.
REINF. STEEL
DRINKING FOUNTAIN.
SOFT®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER HEATER
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FRAMING `� C/�
[
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.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE 1PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING Q
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE S
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. /
J
AS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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 `� C/�
[
FINAL INSP.
ROOFING
7
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA RING ( q1 G
MESH
INSULATIONISOUND -1 v C
FINISH GRADING
FINAL INSPECTION jlCa�to
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
l
GARDEN WALL FINAL