9895 (PAT)ildi
Address
ng ' 44790 Se6lev
Owner
Acacia Homes
Mailing
Address Sable
City Zip
ta
Contractor
Address _
79665 Ave 38
cBermuda Dunes 2192201
State Lic.
& Classif. 539602
Arch., Engr., .
Designer
ice,
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Cf�
No. 9895
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Tel: _
Legal Description
Project Description • PFatio Cover
Tel.:
345-8601
City
Lic. # -
Sq. Ft. 120 No.
Size • - - Stories
No; Dw.
Units
New ❑ Add ❑'. ' Alter ❑ Repair ❑ Demolition'❑
Address
Tel.
City r
Zip
State
f
Lic. #
i ' LICENSED CONTRACTOR'S DECLARATION
)I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
eof
000) ..
ffect.. Division 3 of the1Business and Professions Code, and my license is in full force and
'
.
SIGNATURE /✓`s✓ DATE
OWNER•BUILDER DECLARATION
• I hereby affirm that I am exempt from the Contractors License Law for the following'
reason: (Sec. 7031.5,Business and Professions Coder 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 rile 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 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 civil penalty of not more than five 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
improves .thereon and who does such work himself or through his own employees,..
. builds or hat' such improvements are not intended or offered for sale. If,. however, the building
provided t
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 safe.) ,
Estimated Valuation
1572 .00
-
•PERM.IT - - - AMOUNT
- Plan Chk. Dep. .
Plan Chk. BBI. 29.25
Const. P} . (� Q ,
Mech: ,-
Electrical
Plumbing •
' O I, a'' 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. & P.C. for this reason
S.M.I.' - :20 • ' '
Grading
Driveway Enc. -
Date owner
Infrastructure ,,=
WORKERS' COMPENSATION DECLARATION
' I 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 Code.)
Policy No. Company '
r
t-, ❑ Copy is filed with the city. . O Certified copy is hereby furnished.
1
TOTAL
• CERTIFICATE OF EXEMPTION FROM •
WORKERS' COMPENSATION INSURANCE•
(This section need not be completed If the permit !s 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
=any person in any manner so as1to become subject to.the Workers' Compensation
Laws of California.
Date—Owner
NOTICE TO APPLICANT: If, after making this Certificate of Ex`e'mption 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.
—REMARKS 08"02-9 V
f ar
„x�
- d ti ! r . .
"
_
•
• ZONE: -' 'BY: '
Minimum Setback Distances:
Front Setback from Center Line
Rear SetQ k 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 Cede.) -
'Side Street Setback from Center Line
• •Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR `d
This is a building permit when properly 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 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.
Issued by: Date Permit
Validated by:
Signature of applicant Date.
'
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
FOR. SQ FT ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
a
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL' FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3Ac
HOUSE SEWER
p
FRAMING �1 S �♦�
111
FINAL INSP.
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
a
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS a4
z
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REIIJF
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEE
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
p
FRAMING �1 S �♦�
111
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION CSR(
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL