003072 (BLCK)P.O. BOX 1504 N o .
Building 78-105 CALLE ESTADO
Address 54-545 Avenida Carranza LA QUINTA, CALIFORNIA 92253
Coachella valley T."d. Coo. , . Ltd,
Mailing'
Address32il.�.35Qc1t�
City Zip Tel. '
Past arl d S22fw2 322-- Q2
Contractor
.Starr Construction CO. - -
Address
732 Willims Road,
State Lia ILio #
Arch., Engr.;
Designer
Address Tel.
City Zip State
Lica#
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,%and my license is in full force and
effect r r
SIGNATURE 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, after, improve, demolish, or repair any s!ructure, 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) or
Division 3 of the Business and Professions Code, or that. he As 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 (S500). • •
❑ 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.)
O 1 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. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed if the permit is for one hundred dollars (S100) 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.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the 'Labor Code, you must ' lorthwith
comply with such provisions or this permit shall be deemed revoked.
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 slate 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
003072
.BUILDING:, TYPE CONST. OCC: GRP.
A.P. Number 774-274-013-2.
Legal Description Lot 2. Block 308. Unit 2$
Project Description plan °A"
ZONE:
BY:
Minimum Setback
Distances:
Sq. Ft. 1410 ONG No.
Size- 428 GAR Stories
No. Dw.
Units -
New Add ❑ Alter ❑
Repair ❑ Demolition.0
pence 150,
Side Street Setback from Center Line
Side. Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date 4I27/SPermit
Validated by:
Estimated Valuation
274 1447 _ 310
Validation:
PERMIT
AMOUNT
r
Plan Chk. Dep.
Plan Chk. Bal.
$306.20
Const.
358.00
Mech.
30.00
Electrical
74.22
Plumbing
99..00
S.M.I.
5.22
Grading
20. on
Driveway Enc.
20.00
Infrastructure
1093.$2
TOTAL
$2006.46
REMARKS
a vry nr i L� niflUTA
THAW bili
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 4I27/SPermit
Validated by:
Validation:
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINCS'FEES .a
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. ®
DUCT WORK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
DRAINAGE PIPING
CAR P. SQ. FT. ®
REINF. STEEL
GAS (FINAL)
WALL SQ. FT. ®
DRINKING FOUNTAIN
GROUT
URINAL
SQ FT ®
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
BOND BEAM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
Y1 IROOFING y� — I
y
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRY TRAY
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® I IA c
SEWAGE DISPOSAL
SQ.FT.GAR p 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
ROUND PLUMBING ��
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSEWER
OR SEPTIC T FJ
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. V
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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.
!,Ge FRAMING
20I
FINAL INSP.
N9 f/
Y1 IROOFING y� — I
y
Ub�
IVV
P
/
19
u �
f�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACEU�
SPARK ARRESTOR
GAR. FIREWALL
LATHING '�
MESH
%' N ULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE _FINAL
INSPECTOR'S SIGNATURESIINITIALS,
,
GARDEN WALL FINAL