BLCK (003243)52223 Avenida Madero
003243
P.O. BOX 1504
' No.
Building 78-105 CALLE ESTADO i
Address""= LA QUINTA, CALIFORNIA 92253
Owner r
' MUCE C TEMT, ET. AL.
Mailing
Address p.0. M- 1555 .
City Zip Tel.
TA Q VIMM : - - . 9=1 3 564—M 4104
Contractor
0W,% R/BU1LD1kR
..Address
SAME
IZip
003243
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project•Description RETAI . G VII.M. ~
State Lic.
City
• & Classif.
Lic. #
Sq. Ft., ik9 Lin•yt•No. No. Dw.
Size- --•
• Stories Units
Arch., Engr., _. .... _ . .
• Designer " " ,.
New ❑ Add ❑
Alter ❑ Repair ❑ -Demolition ❑
Address
Tel.
City
Zip
State
Lic.-#.-
ic..#..LICENSED
LIC
.ENSEDCONTRACTOR'S DECLARATION,
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70 OO) of Division 3 o the Business and Professions Code, and my license is in full force and
effect.-
SIGNATURE DATE
OWNER -BUILDER DECLARATION
EStlfnated Valuation
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
-to
permit construct, alter, improve, demolish,=6r 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
- -PERMIT.
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of.
Division 3'of the Business and Professions' Code, 'bi that. he Is exempt therefrom; "and the basis
for the alleged exemption. Any violation Section 7031:5 by 'any. for
Plan.Chk. Dep.
of applicant a permit
subjects the applicant to a civil penaltyof not more than five hundred dollars'($500).
.
.
Plan Chk. Bal.
❑ 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
Const.:
'
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.I.
such projects with a contractor(s)-licensed pursuant to the Contractor's License Law.) •
Grading
O 1 am exempt under Sec. B. & P.C. for this reason.
Driveway
Enc.
' Date .J` 7 Owneri ! .
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.)
Pol icy' N o. Company
❑.Copy.is filed with the city.. . 0 Certified copy.is hereby furnished.
TOTAL
14 {'t0
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, 1 shall not
`` a
ilii• TAP T f<, All_ 1. •=V • Vp
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 or Exemption you .should become
'
ZONE:
BY:
subject 'to the Workers' Compensation provisions or 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
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line '
hereby affirm that thele is a constructiori lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from PTOperty Line
Lender's Name
Lender's Address
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 7/17/87 Permit
agree to comply with all city and county ordinahces and state laws relating to building
construction, and hereby authorize representatives -,of this city to enter .the above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SO, FT. ®
CAR P. I SO. FT.
WALL' ' SO. FT. ®
SO, FTie6
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 ® 11/4 c
SEWAGE DISPOSAL
SQ.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 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.
n/
%L` OND BEAM G
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL