The URL can be used to link to this page

13493 (PLBG)P.O. BOX 1504 Building 52-415 Ave. Carranza 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner William Wilkerson mailing Address City Zip Tel. Contractor R.V.S. Plumbing Add% 1G tierlardo City 1. Zip 922fi4 Te1341-9224 Pc1�:i% i��X't, State Lic. C36 602396 City 232$ i & Classif. Lic. # Arch., Engr., Designer Address . Tel. CityZip j State / Lic. # LICENSED'CO &ACTOR'S DECLARATION I hereby af"' f'V3�e6�th-1111@ licenstnn r -pr visiyns of Chapter 9 (commencing with Section 7000)fof Di us'ne'ss anP oCessi6r�s Cade a d my license,is in full force and effect.�� . f,if f% �!�% t% i 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 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) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Dale 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. ❑ Certified copy is hereby furnished. F CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANC (This section need not be completed i/ the permit is for one hund ed dollars (j100) valuation or less.) j I certify that in the performance of ihp work f r which! thi p�nil is issugd, I shall not employ any person in any manner so,.as-to bexo a ubject,t lh Work rs` Compensation Lawsrof California. — .e % �' - /2. FF 1A If H i�/f 9 1 A I ,UA TO APPLICANT'Il, aftR �rydking Ss?C"ficife /,J4x10&F1dn)jy66VshoZld become to the Workersi Compisa . gr isions o/ the �Lebof Code, you must forthwith with such provision'SArlliis permit sff I be deemed revofrad. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction 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 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— con uilding�— construction, and hereby authorize representatives sof this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 13493 BUILDING: TYPE CONST. OCC: GRP A.P. Number Legal Description sE:eili'E'r onneGtG Project Description ZONE: BY: Minimum Setback Distances: Sq. Ft. Size No: No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Side Street SetbMfrfom=Center Line m"/Proper L nn a. Side Setback fr/I/ FINAL DATE NSPECTOR Date+ �' Issued by: Validated by: Estimated Valuation $ 1 9000.00 PERMIT AMOUNT Plan Chk. Dep. y\ fir% Plan Chk. Bal. Const. Mech. Electrical Plumbing 30.00 S.M.I. Grading A Driveway Enc. ' Infrastructure TOTAL 30.00 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback',from Center Line Rear Setback from Rear Prop. Line Side Street SetbMfrfom=Center Line m"/Proper L nn a. Side Setback fr/I/ FINAL DATE NSPECTOR Date+ �' Issued by: Validated by: IBV f Validation: + y\ fir% CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2 ND FL. SO. FT. @ FORMS SEWER �/, ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. @ GAS (ROUGH) METER LOOP GAR. SO. FT. @ POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. S0. FT. @ GROUT WATER HEATER WALL SO. FT. @ FINAL INSP. DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. @ =$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER I GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACE 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 @ 11/4 c SEWAGE DISPOSAL SO.FT.GAR @ 3/ac HOUSE SEWER 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 �/, 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 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 COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL N2h $3'r ' .. Received From: V�\WI,"I V'1Sl:oL^ `J C( Date: Address: Cj J(o p f Lots) S \�� i4- Account No. `-� ~ �' '' ' Tract Service Address �� t J 1 "C'1 > t `•J� Y (n �^ ;�� G.A. Code J ❑ Meter(s) $ ❑ Service(s) t ❑ Backflow(s) ❑ House Lateral(s) r ❑ DetectorCheck(s) ❑ Me��terSurcharge Sanitation Capacity Charge ❑ W.S.B.F.C. ❑ Temporary Construction Meter ❑ Turn on Charge ❑ Uncollected Account -Name ❑ Inspection Fee -Tract - Fee - ❑ Plan Check Fees Water / Sewer - Tract - ❑ Bond Payment - A.D. - Bond Assmt. ❑ Customer Deposit ❑ Other r. 'l��S• Uu TOTAL $ Remarks - emarks:❑Copy 0 COPYto: ` Cash WaterServic Check it a MoneyCashier Order �&VWD-438 (11189)