PAT (15877)•
414 Q"
• P.O. BOX 1504 No. 15877
Building 78-495 CALLE TAMPICO
Address 54-200 Avenida Mendoza LA QUINTA, CALIFORNIA 92253
Owner i
Mailing
"f l • e3 Guarino BUILDING: TYPE CONST. OCC. GRP.
Address sate as above
A.P. Number
City Zip Tel.
La, QuiEnta 92253 564-2966 Legal Description
Contractor Open Lattice Patio Cover
owner%I�Jt23.2 der - Project Description Pz
Address
City Zip Tel.'
State Lic. City
& Classif. Lic. # Sq. Ft. No. No. Dw.
Arch., Engr.,
Size 256 Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
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, a_nd my license is in full force and
effect. ll
SIGNATURE "4. DATE
OWNER -BUILDER DECLARATION Estimated Valuation
1 hereby affirm that I am exempt from the Contractor's License Law for the following 7075.00
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 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, 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 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 Plan Chk. Bal.
do the work, and the structure Is not Intended or offered for sale. (Sec. 7044, Buisness and Const. 5 • V
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 Contractors 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 contractors) Plcensed pursuant to the Contractors License Law.)
Grading
❑ I am exempt under Sec B. 8 P.C. for this reason
Driveway Enc.
Date Owner 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. 3900, Labor Code.)
Policy No. Company
0 Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL ot • D
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 ( t -7
Date ' { N . Owner `
NOTICE~ TO APPLICANT: d, after making this Certificate of Exemption you should become ZONE: - BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. -
Front Setback from,C nnter Line
Rear Setback fro arop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setb/ from C ter 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 SetbaC er m Prope 1
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. FINAL DATE INOSPV/P�CTOR
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. L
I certify that I have read this application and state that the above information is correct. Issued by: tD a ermlt
I agree to comply with all city and county ordinances and state laws relating to building n
construction, and hereby authorize representatives of this city to enter the above. Validated by: tis /
mentioned property for inspection purposes.
Signature of applicant -Date-
Mailing
ateMailing Address Validation:
City, State, Zip f
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
FOR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING i
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
I
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.
SQ. FT. RESID ® 1'A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESlINITIALS
GARDEN WALL FINAL
see `tete below
•ww11tetter site 6 Species rcy a SheetAlw• at
q.o Lattice
rkbeer ntcA _WA_ e w
ax
C1rti1r ` xtz /-e u
tang Ir
�2/9-:5- log .erns lsta eta" st ie o.s. Below trade
ants*~ lNrpr
1-atsa� or
Angle
1
Provide 1' 4-*«
learanc
ost To �-
iefst �esg.r s>r r.Ita tl«Ste= COACret 1 �
1
as1 �afur se u.tis,� t !�
uj, m���t lla 4 - 1r d "lie K ball r , %:
la:MF". !D ' . 0 Craft
1wm lL1>z2mC bb" "err. r in amt.
COZ LATT at Ir
,i r ,� r `• `. da rear► S4s
R 20-:0 ' �� �► �� , �� ♦ ' goal.
(feet a '
2:4
li
2g'H
10-4
7-11
4-S
4-1 a4
H 1W
US
12' O.C.17-S
$4
1}7 1"
16•1�1
1-1
24•12-4
A
f-2
�7 1-1
2,2•
}11
74
1�
2aA
lt•O.C.1!-l0,21•It-1
12•1>-0
104
10-2 7.4
L_J
f miq son
a• %W Oak" 4112 pitch ung aim. patch W.%h fol
felt ad@ --W Claes A
D. ftw. eu:;miuw. e_mles 4,012 Pitch 11/12 Mir-
p:sdt kth M felt a dr- lay, . Class A
C. Lalt Sp e011sd n o! side to dra_..
d. >t» rte lnl ear+ Fault.
• TYPICAL PNro CHAR