14690 (BLCK)44Q
P.O. BOX 1504 No. 14690
Building
Address 53-720 Ave. Montezuma LA QUINTA, CALIFORNIA 92253
Owner Santa Fe Homes
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address P.O. Box 450
A.P. Number
City Zip Tel.
La Quint8i CA 9.2253 564-x'1866 Legal Description
Contractor Project Description 40' o .51 high, and 36' of
Lendel Ventu: es 4' high garden block wall
.Address
Same
City Zip TeL
State Lic. City'
& Classif. B 638525 Lic. # 859 Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add 0 Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION 1
hereby affirm that 1 am IiGensed under provisions of Chapter 9 (commencitsg with Section
000) of Division 3 of the Business and Professions Code, and my licenseri"s in full force ja
SLGNATURE L�. R-�•kkL'N !; -, r .. DATE
%� / OWNER -BUILDER DECLARATI N'=�^' 1 !�6 oQ
I hereby affigo"that I am exempt from the Contra4toLicense Law for the following Estimated Valuation i
reason: (Sec. 7031'.5,BusieW and Professkms Cod olAny city or county which requires a
permit to construct, after, igorove, damorish, or re r any structure, prior to its issuance also AMOUNT
requires the applicant for such permit to So a signed statement that he is licensed pursuant to PERMIT
the provtstons"-of the Contractor's License Law,i apter 9 (commencing with Section 7000) or
Divlslon 3 X'a, the
and Professions Cade, 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 Plan Chk. Dep.
subjects the applicant to a c/v9 penalty of not more than rive hundred dollars ($500).
❑ I, as owner. of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 45.00
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, Mech.
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 Electrical
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- . Plumbing
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 S. M. 1.
such projects with a contractors) ycensecipursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I her by affirm that I have a certificate of consent to self -insure, or a certificate of
WorkeP mpensatlon Insurance, or a certified copy thereof. (Sec. 3800. Labor Code.)
Polic o. Company
Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL 45.00
CERTIFICATE OF EXEMPTION FROM REMARKS
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: ff, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES -UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN -SECTION 3706 OF THE LABOR CODE, INTEREST, AND -
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
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. Issued by: Date Permit_- -
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-. ''� /`^ Ir-
mentioned property for inspection purposes. Validated by:
Signature of applicant Date I I I
Mailing Address Validation: JI n anf,r
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. ® $
2ND FL. SD. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SO. FT. ® c
BATH TUB
BOND BEAM a a
v
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1I/. c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/.0
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
PER FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE [�f
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM a a
v
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL