MISC (04892)49010 Marimba Ct
04892
P.O. BOX 1504
Buildingti '"0 !>tIIt 3A78-105 CALLE ESTADO
AddressCourt LA QUINTA, CALIFORNIA 92253
Owner ,.„,
Barcon savelopt eAt
Mailing
Address
City Zip Tel.
Cathedral clty 92234 _ 173,..9.024.,
Contractor
'$t aa
Address
State Lic. City
& Classif. .333077 Lic. # 121
Arch., Engr.,
Designer
n
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 Dlvislon 3 -of he,Business and Professions Code, and my license is,in full force and
effect. "•' `'`'t:l :%' {"^rr=:.,».,.........- f d r "
SIGNATl1RE 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 penally of not more than five hundred dollars (5500).
❑ 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 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.)
❑ 1 am exempt under ec. 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. 3900, 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 if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
=any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is arconstruction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I car illy that I have read this application and state that the above Information Is correct.
I agree to comply with all city and county ordinances and state laws retating-,So' building
construction, and hereby authorize representatives of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
ILDING:'TYPE CONST. OCC. GRP.
r. Number Pare La Oi1:$ its
4 892
Legal Description
Project Description Plan 1620. Phase I Lot 41
h
Sq. Ft.Q No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimatea valuation
$84,$22
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
32 5 . 2.2
Const.
3-88.00
Mech.
39.00
Electrical
70.20
Plumbing
82.00
S.M.I.
a
Grading
Driveway Enc.
Infrastructure
1,908.50
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 12/6/88 Permit
Validated by:
Validation:
1
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
(
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT (a $
UNITS
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SO FT. C
DUCT WORK
ROCKSTORAGE
FOUND. REINF. _
MOBILEHOME SVC.
BAR SINK
POR SO FT at
REINF. STEEL
GAS (FINAL) TEMP. POLE
GAR SO. FT. ro
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SO FT. C
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
WALL SO. FT. (d
LUMBER GR,
DRINKING FOUNTAIN
FRAMING' 3 U C
FINAL INSP. O
URINAL
SO. FT. a
REMARKS:
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
,
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHERIAUTONDISHI
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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 @ 1 V: c
SEWAGE DISPOSAL
CERT. OCC.
SO.FT.GAR a 3i.c
HOUSE SEWER
FENCE FINAL
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 8 AIR COND. SOLAR
SETBACK
OUND PLUMBING 37 UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE 3.
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF. _
GAS (ROUGH)
HEATING (FINAL),
OTHER APP.IEOUIP.
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' 3 U C
FINAL INSP. O
ROOFING L
0 ✓ / %/ J
^
O
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND ('
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL