BWFE2015-0260 + RPL (14488)78795 Lowe Dr
BWFE2015-0260
14488
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number: BWFE2015-0260
Property Address:
78795 LOWE DR
APN:
604233005
Application Description:t„ 4,tI
Property Zoning:
r
Application Valuation:
Ij f II
Applicant:
ARUTYUN HARRY FSTKCHYAN
78795 LOWE DRIVE
LA QUINTA, CA 92253
D 4V VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/11/2015
Owner:
ARUTYUN HARRY FSTKCHYAN
78795 LOWE DRIVE
oLA QUINTA, CA 92253
n
AUG 11 2015 l/ Contractor:
ARUTYUN HARRY FSTKCHYAN
CIT(OFLAOUINTA 78795 LOWE DRIVE
NRYOEVELOPMENTDEPARTMENT LA QUINTA, CA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury 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.
License Class: _ License No.::CONV:140528101254109096
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 any applicant for
permit subjects the applicant to a civil penalty of not more than five hundred dollar
($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, 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.).
( ) 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.).
( I am exempt under Sec. . B.&P.C. for th' reason
Date: / " / Owner: c
CONSTRUCTIO 'ENDING 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 (Sec. 3097, Civ. C.). ,
Lender's Name:
Lender's
(818)266-6819
Llc. No.::CONV:140528101254109096
. 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:
Carrier:_ 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 beco a subject to the workers'
compensation laws of California, and agree that, if I sho Id become subject to the
workers' compensation provisions of Section 3700 f• e Labor Code, I shall forthwith
comply with ose provisions.
Date: / r _App cant: fG'
WARNING: FAILURE TO SECURE WO 'COMPENSATION COVERAGE IS UNLAWFUL,
AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official 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 info mation is corcect.
I agree to comply with all city and county ordinances and state law elating to building
construction, and hereby authorize representatives of this city t e ter upon the above-
71
for inspection purposes. r
1
Date: _ Signature (Applicant or Ag Int): ''
d
DESCRIPTION'_
1 .•
FINANCIAL
ACCOUNT
1'
QTY AMOUNT :
PAID
PAID DATE
WALL/FENCE - EA ADDITIONAL 50 LF
101-0000-42404
0 $29.00
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT,
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF
101-0000-42404
0
$47.86
$0.00
PAID BY
METHOD
RECEIPT#
CHECK#
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
WALL/FENCE - FIRST 100 LF PC
101-0000-42600
0
$60.91
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forFENCE OR FREESTANDING WALL- $137.77 $0.00
Description:
•
Type: WALL/FENCE Subtype: Status: UNDER REVIEW
Applied: 8/11/2015 PJU
Approved:
Parcel No: 604233005 Site Address: 78795 LOWE DR LA QUINTA,CA 92253
Subdivision: TR 23268 Block: Lot: 174
Issued:
Lot Sq Ft: 0 Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $0.00 Occupancy Type: Construction Type:
Expired:
No. Buildings: 0 No. Stories: 0 No. Unites: 0
ZIP
Details: ADD ONE COURSE TO WALL NOT TO EXCEED 6' OR 6'3" IN HEIGHT TOTAL 180 LN FEET. E-70' W-52' S-60' SPECIAL INSPECTOR
REQUIRED APPROVED SPECIFICATIONS] PRECISION CONCRETE BLOCK SHALL BE COVERED WITH STUCCO, PAINT, OR TEXTURED
COATING WHERE VISIBLE FROM OUTSIDE THE PROPERTY.2013 CALIFORNIA BUILDING CODES.
78795 LOWE DRIVE
JJ.;
CA
FINANCIAL• •
•
ADDITIONAL
DESCRIPTION ACCOUNT QTY` AMOUNT PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY
NAME TYPE
NAME
ADDRESSI
CONDITIONS
CONTACTS
CITY
STATE
ZIP
PHONE FAX EMAIL
APPLICANT
ARUTYUN HARRY FSTKCHYAN
78795 LOWE DRIVE
LA QUINTA
CA
92253
(818)266-6819
CONTRACTOR
ARUTYUN HARRY FSTKCHYAN
78795 LOWE DRIVE
LA QUINTA
CA
92253
(818)266-6819
OWNER
ARUTYUN HARRY FSTKCHYAN
78795 LOWE DRIVE
LA QUINTA
CA
92253
(818)266-6819
FINANCIAL• •
•
CLTD
DESCRIPTION ACCOUNT QTY` AMOUNT PAID
PAID DATE RECEIPT # CHECK # METHOD PAID BY
BY
WALL/FENCE - EA
101-0000-42404 0 $29.00 $0.00
ADDITIONAL 50 LF
Printed: Tuesday, August 11, 2015 12:37:50 PM 1 of 2
' SYSTEMS
Permit Details PERMIT NUMBER
. City of la Qu inta j y
BWFE 2015- 0260e
DESCRIPTION ACCOUNT QTY AMOUNT PAID PAID DATE RECEIPT # CHECK # METHOD PAID BY CLTD
WALL/FENCE - FIRST 101-0000-42404 0 $47.86 $0.00
100 LF
WALL/FENCE - FIRST 101-0000-426000 $60.91 $0.00
100 LF PC
Total Paid forFENCE OR FREESTANDING WALL $137.77 $0.00
Printed: Tuesday, August 11, 2015 12:37:50 PM 2 of 2 C
SYSTEMS
INSPECTIONS
SEQID
INSPECTION TYPE
INSPECTOR
SCHEDULED
DATE
COMPLETED
DATE
RESULT
REMARKS
NOTES
BOND BEAM
BLD
FINAL"
BLD
FOOTINGS
BLD
Printed: Tuesday, August 11, 2015 12:37:50 PM 2 of 2 C
SYSTEMS
Qin #
Cl ty of La Quin to
Building 8I' Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address:79 Z o Cel e b 1t
Owner's Name: 7FlUc-e-Ui
A. P. Number: / 1
Address: 797 -5 . rL
Legal Description:
City, ST, Zip:
Contractor:
p
• Telephone:. —
O
Address: p W
Project Description:
- 70 14 5,R
yy3u
City, ST, Zip: ' ,? f O up, --Y a ZQ ,v-
TeP0
le h ne• r
w t,
S 2
State Lie. # :
City Lie. #.:
100,
Go
Arch., Engr., Designer:
-v TO
Address:
..
.y
7
City., ST, Zip:
i / _ , ►
Telephone:
. ......... ..
....................
Construction on TYPe• Occupancy:aneY
:
S Lie. ic. #
e (circle one)• New Alter Repair
thP Add'n
Demo
Name of Contact Person:
Sq. Ft.:
#Stories:
# U '
Telephone # of Contact Person:
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
11
Submittal
Req'd
Rec'd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Calcs.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cales.
Called Contact Person
Plan Check Balance
Title 24 Calcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2pd Review, ready for corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S.M.I.
H.O.A. Approval
Plans resubmitted
Grading
IN ROUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees
P.O. Box 1504
LA QUINTA, CALIFORNIA 92247-1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING & SAFETY DEPARTMENT
PROPERTY OWNER'S PACKAGE
(760)777-7012
FAX (760) 777-7011
Disclosures & Forms for Owner -Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of the property
improvements specified at
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your
responsibilities and possible risk you 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.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION.
DIRECTIONS: Read and initial each statement below to signs you understand or verify this information.
0 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 my property.
2. I understand building permits are not required to be signed by property owners unless they are responsible for the
construction and are not hiring a licensed Contractor to assume this responsibility.
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
own.
01, 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on
permits and contracts.
° . 5. I 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 "employer"
under 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
risk.
Tz!'k. 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.
8. I 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 sustained by any subsequent owner(s) that result from any latent construction defects in the
(workmanship or materials.
'J 19. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue
Service, the United States Small -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 (CSLB) at 1-
800-32 1 -CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors.
ri, 10. 1 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 responsible for proposed consiruction activity at the following address:
11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govem 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 I
have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with
someone who does not have a license; the Contractors' State License Board may be unable to assist you with any financial loss
you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. 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 for damages. 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 coverage.
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 the permit. Note: A copy of the property owner's driver's license, form notarization, or
other verification acceptable to the ncy is required to be presented when the permit is issued to verify the property
owner's signature.
Signature of property wner 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 AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize
the following person(s) to act as my agent(s) to apply for, sign; and file the documents necessary to obtain an Owner -Builder
Permit for my project.
Scope.of Construction Project (or Description of Work):
Project Location or Address: 7 X%/ipS_ ZeVCt/ e—
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above
information and certify its accuracy. No e. 4 copy of the owner's driver's license, form notarization, or other verification
acceptable to the agency is required t presented when the permit is issued to verb the property owners signature.
Property Owner's Signatur . Date: /f r /
Nei
CALIFOM\1 , " DRIVER L'I E, `
DL C096867-4
Exp 03/29/2016 END NONE
y LN FSTKCHYAN -
FN ARUTYUN
6525 VARNA AVE
VAN NUYS, CA 91401
ORB 03/29/1958
, A t{# NONE X3291958,.
9,.
SEX .M H - EYES BRN '.
HGT 6'-00" WGT 160 lb —1 I
DD 03/1612006SISRSIBBFD116,. 02/11/2011
1
-7 CITY. OF LA QUINTA.SUB-CONTRACTOR LIST
JOB ADDRESS / ow Ili c , - -Y
PERMIT. NUMBER _ OWNER 1 T M .14, BUILDER
This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work
on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. ( Failure to comply will result in a stoppage of work and/or the voidance
of building permit. For each applicable trade, all information requested below must be completed by applicant. On File" is not an acceptable response:
Trade C assificati:::...>::>::> :>;::::<.:::;r>'>.:
:: n r tor...:........_ ............
Co t ac
............................ .......................... tate Con ;;:;:.::.::::;:.:;::::.;:.;:: ;:.> .;:.::.::.;:.;::
.........
tractor s License .............. B ......
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orkers en afro Ins e
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x/xxExP.Carrier Name Policy EDate License Number Exp (xx/xx xx) (e. . State Cax xxxx) xx/x(e 9 C _8C rPanY Name Classifica ion License Number Date xP
A B xxxxx lCom Format ries xx/xx!xx)
.
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FO
REBAR._PLAC.EMENT
I LLUSTRATfQ.. ..
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DESIGN PARAMETERS:
ACTIVE SOIL PRESSURE (PSF)
=30
PASSIVE SOIL BEARING (PSF)
=150
COEFFICIENT OF FRICTION
= 0.25
ALLOWABLE SOIL BEARING (PSF)
=1500
WIND = 80 MPH, EXPOSURE C
SEISMIC:
NA= 1.3. Nv=1 .6. Z=0.4, SOIL PROFILE=SD
(PICAL)
i AND BOND BEAM
LITH REBAR TO BES
ROUTED
ROUT ENTIRE WALL - USE
IESH AS APPROPRIATE)
(TYPICAL)
=BAR SHALL HAVE A
M OF 31, CONCRETE
'ER AT FOOTINGS
WESTERN RIVERSIDE COUNTY CODE UNIFORMITY PROGRAM
VAf
Tdf ot
FREESTANDING BLOCK WALL
PHONE (760) 777-7125 78-495 CALLE TAMPICO
LA QUINTA, CA1.1FORNIA 92''253
rAX (760) 777-7011, 1 10/9/2014 1 COMMUNITY DEVL'LOFh1ENT DEPT. FACE 2 OF 2
I SLOPES'TO BE AT LEAST 5 TO
DAYUGIiTAt SHOWN'BELOW.
J am IH < YERTICAL
22" #f4 0 48" 4
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6'
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I SLOPES'TO BE AT LEAST 5 TO
DAYUGIiTAt SHOWN'BELOW.
J am IH < YERTICAL
22" #f4 0 48" 4
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CON$1MCTION
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I
REGULATION5.)BEF'OREBEGINNING CONSTRUCTION, ' STEEON isLA6i ANO SUPPORTED -3" ABOVEAND
Mf)i $PACING
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B) 06 WATER COURSE OR NATURAL ORAINAGE SHALL BEAVYAY fROM THE SURROUNDING EARTH/DIRT:
,.
OBSTRUCTW' 2)fmpAI3/_ErepaQI,fC;BOND13EAMRCBARAND -
MBAR INC$IIER
_
4) GROUT NLY THE CELLS CONTAINING RESAR, THIS WALL VERTICAL REBAR IN PLACE- INSPECTION PRIORTO
IS NOT DESIGNED ICOR ALL CELLS TO BE GROUTED. PL ACING GROUP.
0 ALLAEBAR TO`BE ASTM $PEC. A&I 51 GiMok"40 MINIMUM. 3).EUJAL: AFT>;R GROLIT'IS.PLACED -PRIOR TO ANY
6) -ALL, 1415BAARUIP'BOU6159716-Be DECORATIVE CAPPLACF.'MENT.
7) ALL K ASONRY UNIT$ `M:BE ASTM C-90 GRADE N.
#4NORKaNiAL:REBAR CCNTINUbts
8) REBAR TO BE CENTERED IN YASONRY CELLS. '
'WVexyveq>RI+reRat4e COUNTY COOS UNIFORMITY PR6L4RAM
f;
4T32'k MAX. ASOVE.TOP OF RETAINING WALL, -
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6'
MAX
ANALYSIS. L)SE' Off' THIS' STANDARD DE:a'GI+t
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ALLS TAMIE O
IMPLIED OR INFERRED'GUARANTEEAGAINSTr' Pli01,1E(fi6Cfrn"=Ti2S LA Q(7tNTA CALIFORNIA9235
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BUILDING & SAFETY DEPT.
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T'HE 1704 (OWING UNSrSC'lQNS,.ARF_REQUIRE
,
1).EOOT,ING:EXCAVATION TRENCI4CLEAN'WITM'STEELINPLACE AND SUPp0►2YED
,gtJ 0091)NGs ADrACEM To
3" ABOVE ANTS AWAY FR014CTHE SURROUIJpfNO>rAIYTI VpIRT.: -
SLAPESTO'BEAT,IFAj15'TO
,
12) REBA8+CP F_4;RO :: BOND BEAM REEb1R.AND VERIICA1.'REE3API IN PLACE 1
OAYI 1GHfiAS SWOWN BE1 OW.
INSPECTION PRIOR TO PLACING GROUT.
=•.:
3) FWAU AFTER GROUT IS PLACED PRIOR YO ANY DECORATNE CAP PLACEMENT. b
x
1) FENCE HEIGHTS ARE REGULATED CONSULT ZONING REGULATIONS
BEFORE SEGINNING'CONSTRUCTLO". „
lool"M
2) NO WATER C6l1RSE OR NATURAL, DRAINAGE SHAL BE
FOOT
OBSTRUCTW.
, -r
3) ALL RE9AR l'O BE ASTM SPEC, A6 t 5, GRAi3H
40'MIN1tMUM. 'SEE PAGE 2 FOR ADDMONXL.iN#OF"A Tjbw
4) ALL RE13AR LAP SP1J E5 fi0 BE_24` MtN(MiiM
5
) ALL MASONRY UNITS TO BEASTM .`- O C3[iADE ty'•'
;' x r ; WesTERN ItivERSLDE COUNTY CODE UHIFORMTTY PRlIeRAM
6) NOy Diad% i€D ,,D)2 bood4 ,ATIC E LodTiS .dM ,*
- VEHICLES OR STRUC• es
ALTERNATE DESIGNS -MAY ',9E POSSIBLE
BLOCK WALL
WHEN PROVIDED WITH AN ENGINEERED i
ANALYSIS. USE OF, THIS STANDARD -DESIGN
"
ATOP 21 RET` MNN G WALL: :..,
a5'AT- THE USER'S`_'RISK-AND'`CARRIESNO-•j`
PHOFIE (7 J T77+7tZ3
78.495.CALGETAMP109
IMPLIED OR:INFERRED GUARANTEE AGAINST ,
to QUMA, CALdFORN1A922S9
FA 1CU12E OR DEFECTS."
.. .. ,. y
FAX (!60) 777-70I L°°=
Io/s/ooL+ 10DUMCMITYIDMIJWUMTOM.1 Mgs t ors
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CON$1MCTION
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CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CON$1MCTION
• EXOPI CG RO4t <
ZO L ac 6
! R0D OCL- couP.SC
• G (rT t'R(-i- G ko u i
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LOWE ST.
(CARLOS
SANCH EZ
DRAFTING • DESIGN LAND PLANNING •
CARLOS SANCHEZ
DESIGNER
45-175 PANORAMA DR
SUITE E
PALM DESERT, CA
(760)272 -9117 -Phone
CASHCLA@GMAIL.COM
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8 u& w4G mf
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t
LOWE ST.
(CARLOS
SANCH EZ
DRAFTING • DESIGN LAND PLANNING •
CARLOS SANCHEZ
DESIGNER
45-175 PANORAMA DR
SUITE E
PALM DESERT, CA
(760)272 -9117 -Phone
CASHCLA@GMAIL.COM
•
:6 f
ht 4
r P.O. BOX 1504
BL}ding 78--795 Lowe Dr. 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253 .
Owner
BreezeLand
Address 42.335 Washington 5t. P310
Aftm Desert, Cly Zip92211 Te 60-5557
tr VorSQ@C,a1t,SB
Address
73-373 Country Club Dr. #701
Dist Desert,ZiP92261 W19) 346-4393
State Lic. City
& Classif. B 675422 1 Lia # 2934
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the BtAiness and Professions Code, and my license is in full force and
effect.i
SIGNATURE +" ' %' " - I DATE
OWNER -BUILDER DECLARATION
I hereby affiryn 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, after. 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 bulld 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 contractors) pcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
WorkI hereby affirm that I have a certificate of consent to self -insure, or a certificate of
er's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any pperson In any manner so as to become subject, to the Workers' Compensation
Laws of Caltfomia
Date Owner
NOTICE TO APPLICANT: It, 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 tMs permit shall be deemed revoked.
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
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
expiration if work thereunder is suspended for 180 days.
I certify that 1 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
ateMailing Address
City, State, ZIp
No. 14488
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description Tool and Spa
.171 1. f . • of 6' high black wall
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
tool/Spa $8,000.00
Estimated Valuation Wa3l 4,275.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. 64.3►
Const. 99.00/72.00
Mech. 24.00
Electrical 45.00
Plumbing 27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure . '"
M1 iw4 i W rf Jww• V L
3% -w -3a
TOTAL 358v -3e -
REMARKS
8 REMARKS 4 0. 35
1 1 UE. ijiltbua fee for butJ1,135.11lig Work 'oil
+ i
With:L iii • i„ x
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Ine
Rear Setback from R rop. e
Side Street Setbac jr , Ce i
Side Setback from/ eOrt yCLLiine
FINAL DATE A SPECTOf3P
Issued by: Datedy P rmit%
Validated bv:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. @ $
2ND FL. SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11A c
SEWAGE DISPOSAL
J `0✓7
V
SO.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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 _ I ELECTRICAL I HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMB
UNDERGROU
i
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI TANK
ROUGH WIRI G
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
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
J `0✓7
V
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
TE;: LEVE ROOM FOR FUTCHER HEATER
JN GAS LINE
IRLINE
-BOX .
A1/ES
?21f•;
ti. r n s f'
TILE DAMWALL f LYS
R7'-0"
V
f
C `
G
;/'
''l
A,
C
1
[
L
f
C `
G
;/'
AFI, : """- T,.N.. , r , • 40
*, . a,<
.r r W
P O BOX 1504
Building
Address
Owner
78-495 CALLE TAMPICO
78-795 Lowe Dr. LA QUINTA, CALIFORNIA 92253
Hreezland Inc.
Mailing 42-335 Washington F310
AddresCity lZip Tel.
Palm Desert, ["A 92211 (619)360-5557
Contractor
Executive Construction
ss
AddT734 Country Club
Cit! Zi Tel.
Yalm Desert, PA 92211 (619)360-5557
State Lic. City
& Classif. g 360038 Lic. #
Arch., Engr.,
Designer Hacker Engineering
A`6 it7 Hwy Ill Te(619) 324-0216
City Zip State
t;athedral Citi I, CA 92234 Lic-#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that Fam licensed under Drovisions of Chapterj6 (commencing with Section
7000) of Division 3,of the Business and Professions,Code„an y license s to full force and
effect. /W +• ! `
SIGNATURE '`^ IF DATE
IF 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 ($500).
— 1, 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 itis own employees,
provided that suchimprovements 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.)
1, 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 properly 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 ($100) valuation
of 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, alter making this Certificate of Exemptionyou 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.
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
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
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
7 41
•J
No. 142;.zF;
BUILDING: TYPE CONST. Vn OCC. GRP. R3
A.P. Number 604-233-005
Legal Description Lot 174 Tract 23260
Project Description SFd
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 Propggy Line
FINAL DATE
INS
Issued Dated OCT 2 8
Validateded by: III
Validation: I Rv Y
J
Sq. Ft. 2105
Size
No.
Stories
No. Dw.
Units
New 0 Add D
Alter O Repair u Demolition ❑
Permit dons not include
block wall
or pool.
Estimated Valuation
$124,062.00
PERMIT
AMOUNT
Plan Chk. Dep.
2b • UT
Plan Chk. Bal.
3b2.00
Const.
/2/.Uu
Mech.
it
Electrical
14/.14
Plumbing
62.Uu
S.M.I.
Ii. 41
Grading
Driveway Enc.
UU
Infrastructure2,791.40
ry
'
z i.a r
C.
tucdt9
TOTAL
y ► . 11
4 , J 'i . t x
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 Propggy Line
FINAL DATE
INS
Issued Dated OCT 2 8
Validateded by: III
Validation: I Rv Y
J
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES" t
tj
1ST FL. SO. FT. ® $
2ND FL. SO. FT. rg
POR. SO. FT. @MOBILEHOME
GAR. SO. FT. ®
CARP. SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
SVC.
POWER OUTLET
tN I
YARD SPKLR SYSTEM -
BAR SINK i
IROOFDRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING 1
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)(DIS H)
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® t 14 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3.c
HOUSE SEWER
FINAL INSP.
ROOFING
GAS PIPING
PERMIT FEE
REMARKS:
PERMIT FEE
PERMIT FEE
DBL t
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING A ELECTRICAL HEATING 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. 1
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC K
IROUGH 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
WATER SYSTEM
FINAL INSP.
VVV
wt
GRADING
cu.yd.
$ -Plus-XS-=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
p r qJJ
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTIONFL
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
DESERT SANDS UNIFIED SCHOOL DISTRICT
82-879 Highway 111
NOTICE: Indio, CA 92201
Document Cannot Be Duplicated 619-775-3500
Date 110/27/941 Type, of Permit La Quints
No. 113154 Permit #
Log
Owner Name Breeze Land Inc.
No. Street see below
city La Quinta Zip 92253 Study Area 232
APN # Tract # Lot # 0 Square Footage 18106
Type of Development Single Family Residence No. of units
Comments 78-805,78-785,78-815,78-795 Lowe Drive
At the present time, the Desert Sands Unified School District does not collect fees on
garages/carports, covered patios/walkways, residential additions under 500 square feet,
.detached accessory structures or replacement mobilehomes. It has been determined
the above-named owner is exempt from paying school fees at this time due to the
following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to Government Code 53080
in the amount of 1.72 x 8106 or $ 13,942.32 have been paid to D.S.U.S.D. for
the property listed above and that building permits and/or Certificates of Occupancy for
this square footage in this proposed project may now be issued.
Fees Paid By
Charles E Lester
Name on the check
By Dolores A. Ballesteros
Telephone 360-5557
Superintendent
Fee collected /exempted by Mary Lou Lopez
Payment Received,,",'
Signature `
, .tieck':No. 3816 '•
Collector: Attach a caWXof county or city plan c c pplication form .to district cop; ..for all %vaivers.
Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy Accounting ` , ;
4
P.O. BOX 1504
Building 75--795 Lova Dr. LA Q
Address UINTA, CAL FORN A 92253
BreexeLand
Mailin
Address 42335 Washington 3t. P310
City
Pact L t Desert, CIZ
ip
92211
Tel.
360-5557
Contractor
V A P Specialties
Address
73-373 Country Club Dr. #701
Atyiiia Desert, Cs
Zip 92251
Tel -19) 346-4393
State Lic.
City
& Classif. ,B 675422
Lic. # 2934 .
Arch., Engr.,
Designer
Address
I Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
000) of Division 3 of the } Bus iness nd Professions Code, and my li she is in u I for and
feet. / /r / • •'iLf
$IGNA7URE>'I DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,eusiness and Professions Code: Any city or county which requires a
permit to construct, after, 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 dull 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
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) #tensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
Thereby 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
. Iy is filed with the city. ❑ 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 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. N, 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. '
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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
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
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
BUILDING: TYPE CONST
Number
No. 14492
OCC. GRP.:
Legal Description
Project Description Change of Contractor, see
Penait. 114 2 56
Sq. Ft.
Size
New ❑
No. No. Dw.
Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
uation —0—
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
AMOUNT
TOTAL —0—
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEE!
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT. ®
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
-
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Ye c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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
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 SIGNATURES/INITIALS
GARDEN WALL FINAL