9752 (RR)Building
Address
Owner
P.O. BOX 1504
78--132 3 ago LA QUINTA, CALIFORNIA 92253
..Norman Barker
Mailing
Address 78132 Lago
City Zip Tel.
I_a• Quinta 92253
Contractor
No. 9752
BUILDING: TYPE CONST. OCC: GRP.:
P. Number
Legal Description
Description
Roof Encloawre
78341 narbv Road
City
Zip
Tel.:
Indio
92281
345-1349-
45-'j349State
StateLic.
City
& Classif. B 400211
Lic. # 354
Sq. Ft.
3�1
No. No. Dw.
Arch., Engr.,
Size
Stories Units
Designer =1111M Cliff Cama
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
s an3A as -above
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION .
Ilhereby affirm that I am licensed underprovisions of Chapter 9 (commencing with Section
7 00) of Dlvislo'n 3 offtth`e-Business and' Professions Code, and my license is in full force
and
fact.
••'..
G TU _ DATE_
' OWNER -BUILDER DECLARATION
EStlmated Valuation
I hereby affirm that I am'exempt from the Contractors License Law for the following
2�g
• reason: (Sec. 7031.5,Business. and Professions Code: Any city or county which requires a
I •
`.60
permit to construct, atter, Improve, demolish, or repair any structure, prior to its issuance also
- •requires the applicant for such permit to, file a signed statementthat he is licensed pursuant. to
PERMIT`
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
_
t, -"Divlslon 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basisr
the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
Plan Chk.'Dep-
- ` subjects the applicant to a civil penally of not more than five hundred dollars.(8500).
I,'as the
Plan Chk..Bal.
' 7 5
'172.25 C
owner of property, or my employees with wages as their sole compensation, will
the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
'Professions
Const.
ti - 265.00
- 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-
Mach.
that' such'improvements are not intended .or offered for sale. If, however, the building
1
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.)
s (�
❑ I, as owner of the property, amexclusively 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.
2..70
•. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
r
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 S Zrit� ''13IIP"�
.9 Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
482.59
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE p t Y �i
(This section need not be completed 11 the permit is for one hundred dollars (5100) valuation --,i<}i} p _. ,{j• i, e �Qjg;^25—'A' �„� i'7
or less.) .. ••x a .s
I certify that in the performance of the work for which this permit is issued, 1 shall not Q 4
employ any person In any manner so as to become subject to the Workers' Compensation
Laws
of California
Date Owner
NOTICE TO APPLICANT: It, after 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
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 It 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
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
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO, FT. @
CAR P. SO. FT.
WALL SO. FT. ®
SO FT ®
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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
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% c
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® Vic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
G
GROUND PLUMBING `
UNDERGROUND la GlA19
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSMy
SEWER OR SEPTIC TANK
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
CtL-0L
`
K Y 7 a o f Cb
y�
(/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
G . FIREWALL
THING qt' C.v%
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL