10532 (BWFE)54680 Avenida Alvarado
IIIIIIIIIIIIIIIIIIIIIIIII 68
IE
Building 54-680 ALVARADO
Address
4 4 athit' o. 10532
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
GENERAL CONTRACT MANAGEMENT
Mailing
Address
P 0 BOX 59
City
LA QUINTA
Zip
92253
Tel.
564-1486
Contractor
SAM P
Address ..
BUILDING: TYPE CONST. OCC: GRP.•
A.P. Number 674-273-009
•
Legal Description
Project Description 59' X 3 4/2 BLOCK WALL
and Grading Permit
City
Zip
Tel.:
State Lic.
& Classif. 524325
City
Lic. #
1235
Arch., Engr.,
Designer
Sq. Ft.
Size
No.
• Stories
No. Dw.
Units
New 0 .Add 0
Alter 0
Repair 0
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.
SIGNATURE
DATE
OWNER•BUILDER DECLARATION •
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness 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 Ucense 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 live hundred dollars ($500).
O 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 toanowner 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. ll, 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). Ilcensed pursuant to the Contractor's License Law.) .
O I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate.,ofconsent to self -insure, or kcertificate of
Worker's Compensation Insurance, or a certified copy.th'ereof (Sec.,3Co
800r abor de.)
Policy No 4'..;/s"I., / : .Company
Copy is tiled 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 (5100) 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 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
Estimated Valuation
$750.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
$25.00
Mech.
Electrical
Plumbing
S.M.I.
.10
Grading
Driveway Enc.
Infrastructure
TOTAL
$25.10
REMARKS
r, 'kr:4 S+" 4 ' '1'4 A( "1^_-(3 i, ll
LASH r13rA j 25..f} f
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
Validated by:
Validation:
Permit
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL
SO. FT.
SO. FT.
SO FT
SO. FT.
SQ. FT.
SQ. FT.
SO. FT.
VALUATION
@
$
A.C. UNIT
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
2ND FL.
STORAGE TANK
FORMS '
SEWER OR SEPTIC TANK
ROUGH WIRING.
YARD SPKLR SYSTEM
ROCK STORAGE
POR
@
GAS (ROUGH)
METER LOOP
MOBILEHOME SVC.
HEATING (FINAL)
OTHER APP./EQUIP.
BAR SINK
GAS (FINAL)
GAR.
®
POWER OUTLET
WATER HEATER
SERVICE
ROOF DRAINS
FINAL INSP.
CAR P.
BOND BEAM //3VerM
( III III (
WATER SYSTEM
GRADING
cu yd
x$ =5
LUMBER GR.
DRAINAGE PIPING
FINAL INSP.
WALL
plus
FRAMING
FINAL INSP.
ROOFING
DRINKING FOUNTAIN.
,
REMARKS:
®
VENTILATION
FIRE ZONE ROOFING
URINAL
ESTIMATED CONSTRUCTION
$
SPARK ARRESTOR
WATER PIPING
GAR. FIREWALL
• NOTE: Not to be used as property tax valuation'
LATHING
FLOOR DRAIN
MESH
MECHANICAL FEES
INSULATION/SOUND
WATER SOFTENER
FINISH GRADING
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
L.0
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARBAGE DISPOSAL
GARDEN WALL FINAL
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.
SO. FT. RESID @ 11 c
_
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Ac
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
SETBACK
/
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS '
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
- •
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM //3VerM
( III III (
WATER SYSTEM
GRADING
cu yd
x$ =5
LUMBER GR.
FINAL INSP.
$
plus
FRAMING
FINAL INSP.
ROOFING
,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION- ll l / 311
i
L.0
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL