12-0807 (BLCK) + 3079 (SFD)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
IIIIIIIIIIIIIII�IIIIIIIII 07 ‘gr-4.14,Otwai
Application Number:
Property Address:
APN:
Application description:
Property Zoning:
Application valuation:
Applicant:
12-00000807
54045 AVENIDA ALVARADO
774-202-024-2 -000000-
WALL/FENCE
COVE RESIDENTIAL
3289
Architect or Engineer:
PIA
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Owner:
RHONDA DONAHUE
54045 AVENIDA ALVARAD
LA QUINTA, CA 92253
Contractor:
Owner
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
CITT OF FINANCE
DEPT.
/19/12
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 70001 of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: License No.:
Date: Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
aanapplicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S5001.:
I 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, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
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 or she did not build or
improve for the purpose of sale.).
1 ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 ) I am exempt under Sec. , B. .C. for this reason
ate:
te+ J t/ .6wner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued ISec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
P f t`
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Policy Number
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,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the Labor Co I shall forth ith co ith those provisions.
ate: ` 1+� plicant:
Carrier
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS 15100,0001. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPUCANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers; agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
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 iscountyto ente 1' u n the above-mentioned property for inspectio purpotes
ate: 4.2 l
`Signature (Applicant or Agent): 1'�V aL/
Application Number 12-00000807
Permit WALL/FENCE PERMIT
Additional desc
Permit Fee . . 63.00 Plan Check Fee .00
Issue Date . . Valuation . . 3289
Expiration Date 1/15/13
Qty Unit Charge Per Extension
BASE FEE 45.00
2.00 9.0000 THOU BLDG 2,001-25,000 18.00
Special Notes and Comments
90 L.F. COMBO WALL, 2' RETAINING, 6'
GARDEN, .48 L.F. 5' COURTYARD WALL + 2
COLUMNS FOR GATE, CITY STANDARD. 2010
CODES.
Other Fees
BLDG STDS ADMIN (SB1473) 1.00
Fee summary Charged .Paid Credited Due
Permit Fee Total
Plan Check Total
Other Fee Total
Grand Total
LQPERMIT
63.00
.00
1.00
64.00
.00
.00
.00
.00
.00
.00
00
.00
63.00
.00
1.00
64.00
$31
(tor•isimitribo
4,14w dLAI
WL .
C$/' vk I0 e— Taetc4-41 4ArbkU RLo 1L
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATE/(R 42BY V -b
•
•
3 C1 i-- S
-sr I tau 44242
(5' i*ltvf-)
r
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
(760) 777-7012
FAX (760) 777-7011
PROPERTY OWNER'S PACKAGE
Disclosures & Forms for Owner -Builders Applying for Construction Permits
.INT RT Y7? 1!(OT10E TO PROPERTY OWNER
. Dear Property Owner
An. application for a building permit has been submitted in yo
improvements specified at name listing yo >:elf as the builder of the property
g o %a ( O .C�1 �. • f. h L. �3
•
We are providing you with an Owner -Builder Acknowledgment and Information -Verification Form to make you a of your
• responsibilities and possible riskyou may incur by having this: permit-issued:in your name as the
Owner -Builder. We will not issue a building. permit until you.have read, initialed your. understanding of each'provision,
signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice
unless you, the property owner, obtain the prior approval of the permitting authority.
Off; S ACKNOWLE ► ' 'LW_ AND • inFICA t N OF.fl OR A N
DMECt'7ONS: Read and initial each: statettrent bdow'ta sign6 you understand or ver.* this information.
1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -Builder" .
building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as
an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person
and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those
injuries. I am willfully acting as an Owner -Builder and am aware of. the limits of my insurance coverage for injuries to workers
on y property.
co
2. I understand building permits are not required to be signed by property owners unless they are responsible for the
etion and arenot hiring a Licensed Contractor to assume this responsibility.
3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect
myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my
4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
ermits and contracts.
5.1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value
of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe?'
`ceder state and federal law.
6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal
government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment
compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial
7. I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential
structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed
subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed
under contract with a licensed general building Contractor.
It
8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any
financial or personal injuries sued by any subsequent owner(s) that result from any latent construction defects in the "
w. • l l : t. hip or materials. •
' 11°9. I understand I mayobtain more information
regarding my obligations as an "employer" from the i' Re -Venue
Service, the United States Sniall Business Administration, the California Department of Benefit Payments, and the California
Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (C3tl) at 1-
80-321-CSLB (2752) or www_cslb.ca.gov for more information about licensed contractors.
IO. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the
party legally and financially re^sponsible for proposed construction activity at the following address:
I1. I agree that, as the party legally and financially responsible for this proposed construction activity,.1 will abide by all
ble laws and requirements that govern Owner -Builders as well as employers. •
12. I agree to notify the issuer of this form immediately of any additions; deletions, or changes to any of the information 1
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who doesnot have a license, the Contractors' State License Board may be unable to assist`you with anyeial loss
you may sustain as a result of a complaint. Your oltly remedy against unlicensed Contractors may be ir1'civil coca. It is also
important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working
on your property; you may be held liable fordamages. If you obtain a permit as Owner -Builder and wish to hire Contractors,
you will be responsible for verifying whether or not those Contractors are properly licensed and the Status of their workers'
compensation insurance Cover.
Before a building permit can be issued, this form must be completed and signed by the property owner and returned to
the agency responsible for issuing tho.permit. Note: A copy of tkcproper owner's ihiverew.ften farm nota ea. or
other verification acceptable to the agency is required to be presented when the Permit is issued toveriy the property
owner's signature.
Signature of property owner
Date:
• Note: The following Authorization Form is required to be completed by the property owner only when designating
an agent of the property owner to apply for a construction permit for the Owner -Builder. •
AUTHORIZATION OF A. TO A
Excluding the Notice to Property Owner, the execution of
the following person(s) to act as my agent(s) to apply for, si
Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
e ' e�ie11.:7":1:5-
f'la--�. :1, : resports�bility, I hsreby authorize
y `y" _?_:-74 ��•• �r OwQer-Builder
%.44,7 -
I declare under penalty of perjury that I am the property
information and certify its accuracy. Note: A copy of the
acceptable to the agency is required to be presented when the permit is
the above
Property Owner's Signature:
n
.
• BM.#
. .. .
'
. - .
. City of La Quinta •-.
- . Building 8f Safety Division . .
.
- P.O. Box 1504,78-495 Calk Tampko
. LaQuinta, CA 92253 -,(760) 777-7012 .
.
. • Building Permit Application and Tracking Sheet
.
•
A
Permit # cp .
1/)- •
Project Address: 5 LI °Lis icw2. 4t mita°
Owner's Name: . Khzrudjk 1DItS iNkho'R.-.
A. P. Number .
Address: 59 OLA S AVt. A Walead 0
.
Legal Description: . • • •
City, ST, Zip: LA 10‘ NA -0i, CA- CI ';,), S 3
Contractor.
•0 • •
Telephone: .. _
• •
el-W*1r,,
Address:
Project Description:
.
City, ST, Zip: : •
516\e_ arld\
Telephone: ' •
KAI"' '..Wk4'2
City Lie. 11.:
fYart- e_ouLt
W 4ArN•03eAl
a0771-670 a -RUL
qa,r6 .
+ V,,c5u.YZ.
• • q° L P .
State Lic. # : • •
-
!
2 /
. . .
Arch., Engr., Designer: •
. .
'Address:
67 / -a...C.d4, • .2 044-,-Y1-44 • . v
City, ST, Zip:
.., ,...:-
::.1
s:..
•',..a.;.0.44V05,,
-
14 0
. .am---,
'..,,, r)74.,' :
11' Lc. 5 , 47
•
Telephone: . •
'
• • • -
Construction Type: Occupancy: •
State Lic. #: •
, :... etW ••••-•
Project type (circle one): New Add'n Alter Repair Demo
Name of Contact Person: Klemsysack •DiSr\41.0Z
• Sq. FL: # Stories:
# Units:
Telephone # of Contact Person: 7(14 e)( _5G 57
Estimated Value of Project: if it • 0 0 0
.
.
i
. APPLICANT: DO NOT WRITE BELOW THIS UNE • '
Submittal •
Req'd
Rec'd
• TRACKING
• PERMIT FEES
Plan Sets
Plan Check submitted.
Item
. Amount
Structural Cates.
"
Reviewed, ready for corrections
Plan Check Deposit
Truss Cates.
Called Contact Person
Plan Check Balance.
.
Title 24 Calcs.
Plans picked up
.
Construction •
Flood plain plan
Plans resubmitted •
'
Mechanical • .
.
Grading plan •
.
.
2" Review, ready for corrections/issue
.
•
Electrical
•
Subcontactor List
.
Called Contact Person
Plumbing .
.
.
.
. Grant Deed
.
-
•
.
Plans Picked up • -
SALL
H.O.A. Approval
'
Plans resubmitted
•
Grading •
IN HOUSE:-
•
*4 Review; ready for corrections/issue
-
Developer Impact Fee '
Planning Approval.
•Called
Contact Person
A.I.P.P.
Pub. Wks. Appr •
-
•
Date of permit Issue
Schott Fees •
•
•
Total Permit Fees
I 111111111111III11111111108
IE
Building
Address
Qamtip
/� I �/► P.O. BOX 1504
,5- [_o45- E V/'� n,� u�LA DO
QUINTA, CALIFORNIA05 CALLE p 92253
Owner,
0414-1-1
sibCCP.172
Mailing
Address 7
�jZ 5
C) y
f,41.AA S 4/,'1G s
Zip 91ZZ6 2
Tel.
3ZZ-/oZe.)
Contractor
eon
Address
7 z (A/C -C -/,c4,'. s D_4�
APPLICATION ONLY
BUILDING: TYPE CONST. FO OCC. GRP.
A.P. Number Pee-R-C•EL C 77¢- ZvZ - O /Z - 2
Legal Description Z-67'' Z . B4-- /1 'e- ZS¢/ e--(AtZ!y
Project Description PL -PL -,</1/4/'4/ tt A tr
Cit�yr
/,,44.K Sp 2 pcvCS
Zip
Tel:
3Z1-/o?�a
reSvca JO
State Lic.
& Classif. ,A - 5875.34_
City gfc
Lic.#
Arch., Engr.,
Designer #%e 2s9-G7a•e.,
/4/o L1 V.
SFt. 4Z8 No.
Size Stories
No. Dw.
Units
New Add 0 Alter 0 Repair 0
Demolition 0
Address
Tel.
it
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affir that I am licensed under provisions of Chapt ommencing with Section
7000) of DI o 3 of the Business apebProfe ns Code, license is in full force and
effect. 4—/r6 / j 87
ATE
SIGN
TU
OWNER•BUILDER DECLARATION
ereby 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 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
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
of proving that he did not build or improve 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 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
Date Owner
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 •
0 Copy is filed with the city. 0 Certified copy is hereby furnished.
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.)
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
comply with such provisions or this permit 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 properly filled out, signed and validated, and is subject to
expiration it 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.
Signature of applicant Date
.Mailing Address
City, State Zip
FINANCE
Estimated Valuation -74, (9 7
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
_iota-oZo
Const.
Mech.
8,oc
JO -Do
Electrical
Plumbing
S.M.I.
Grading
o26.0a
Driveway Enc.
Infrastructure
do -O¢
/d93„ P a_
TOTAL
REMARKS
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 Permit
Validated by:
Validation:
Building
Address
Mil III1111111109
watt 44adead
54-045 Avenida Alvarado
Owner
Coachella Valley Land Co.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
•
Ltd.
Mailing
Address 732 Williams Road
City
Palm Springs
Zip
92262
Tel.
322-1020
Contractor
Starr' Construction
Address
732 Williams Road
No. 003079
BUILDING: TYPE CONST. • OCC: GRP.
A.P. Number 774--202-012-2
Legal Description Lot 2, Buick 254, Unit 24
Project Description Plan '"A"
City.
Palm Springs
Zip
92262
Tel.
322-1020
State Lic.
& Classif. A
397934
City
Lic. # 7S-1
• Arch.; Engr.,
Designer
Sq. Ft. 1410 CaAPNo.
Size A 2R azitStories
No. Dw.
Units
New C: Add ❑
Alter ❑ Repair ❑
Demolition 0
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.
SIGNATURE4' - DATE
• OWNER -BUILDER 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 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 (S500).
El 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
of proving that he did not build or improve 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 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
Date Owner
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
'•Copy is filed.with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
• WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (S100) valuation
or less.) -
I certify that in the performance of thg 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
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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 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.
Signature of applicant Date
Mailing Address
City, State, Zip
HARD COPY
Estimated Valuation
$74,19;'.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$306220
Const.
358.00
Mech.
30.00
Electrical
74.22
Plumbing
99.00
S.M.I.
5 2
Grading
20.00
Driveway Enc.
20.00
Infrastructure
1893.82
S2flt'M..46
TOTAL
REMARKS
etirttNitzta2
i7L ¶. i
•
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 4 /21 i ermit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL
SQ. FT.
SO. FT.
SO FT
SQ. FT.
SQ. FT.
SQ. FT.
SQ. FT.
VALUATION
@
$
BONDING
UNITS
STORAGE TANK
?II1ORMS _ / — 7
/
/ EWER OR SEPTTele6 rrrr���(� 7
��
��II `�GAAS
e OUGH WIRING 736-8')
2ND FL.
®
ROCK STORAGE
FOUND. REINF.
(ROUGH)
METER LOOP
HEATING (FINAL)
YARD SPKLR SYSTEM
REINF. STEEL
GAS (FINAL)
POR
®
MOBILEHOME SVC.
WATER HEATER
SERVICE
BAR SINK
GAR.
@
GRADING
cu yd
POWER OUTLET
LUMBER GR.
FINAL INSP. /O/332.
ROOF DRAINS
plus
WERAMING 7_30 i
CAR P.
@
/ / i /el A ////
ROOFING ( // �/i'/'/
9/1, i/V7
- -�j,�
24./..)
REMARKS:
DRAINAGE PIPING
VENTILATION
WALL
FIRE ZONE ROOFING
FIREPLACE
DRINKING FOUNTAIN
SPARK ARRESTOR
®
GAR. FIREWALL
LATHING
URINAL
ESTIMATED CONSTRUCTION
$
FINISH GRADING
FINISH
i
WATER PIPING
FINAL INSPECTION
NOTE: Not to be used as property tax valuation
CERT. OCC.
FENCE FINAL .
FLOOR DRAIN
INSPECTOR'S SIGNATURES/INITIALS
MECHANICAL FEES
GARDEN WALL FINAL
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 USEPERMIT 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
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1,4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4c
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
—/—
2
(tL /(GROUND PLUMBIN(6i'7
UNDERGROUND
A. UNIT
COLL. AREA •
/SETBACK
J�GLAB GRADE 7- /- )
4��/_Fl_.0
OUGH PLUMB.,_3U_C-"?
BONDING
HEATING (ROUGH)
STORAGE TANK
?II1ORMS _ / — 7
/
/ EWER OR SEPTTele6 rrrr���(� 7
��
��II `�GAAS
e OUGH WIRING 736-8')
DUCT WORK
ROCK STORAGE
FOUND. REINF.
(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu yd
4 =$
LUMBER GR.
FINAL INSP. /O/332.
$
plus
WERAMING 7_30 i
FINAL INSP.
gf
/ / i /el A ////
ROOFING ( // �/i'/'/
9/1, i/V7
- -�j,�
24./..)
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
L�IDISULATION/SOUND—/C/ ��
r
FINISH GRADING
FINISH
i
FINAL INSPECTION
CERT. OCC.
FENCE FINAL .
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL