13039 (BLCK)Building
Address 51-925 ftbio
Owner
Randy Eckhardt
Mailing
Address Same,
City Zip
La..Qi2iiita, •CAI 92253
Contractor
Address
City Zip
State Lic.-
P.O. BOX 1504 NO. 15W
�..-78-105 CALLE ESTADO
�LA`QUINTA; CALIFORNIA 92253
BUILDING: TYPE CONST. OCC'. GRP.-
A.P. Number
Tel.
Legal Description
.`20 of 4' tOgh wall -
Project Description
130' of 6' high -va'11
Tel.'
p &Classif.,, Lic #r.
,
Arch.; Engr.;,
Designer
Address TT_
Sq. Ft. ",,No.
Size Stories
New 0 Add El
No. Dw.
Units
;pair 0
Demolition 0
City,
State
TP
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section'
7
0 00) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
DATE
OWNER -BUILDER DECLARATION
I'hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation $3,780-31
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 the Contractor's
PERMIT -AMOUNT
provisions o/ 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
forthe alleged exemption Any
Section 703 1 5
Plan Chk. Dep.
violation of by any applicant for a permit
sbj I the applicant a civil penalty 0 not live
c v p y 1 0 more than
he ft hundred dollars S 5
0 rs ( 00)
c a P1`c t toContractor's
a owner
so t r m employees with
of he property, th wagesa their
0 y m s g S I compensation,
r sole
o e comp ion, will'
Plan Chk. 'Bal.
d 'Professions the work and he
0 1 structure s not
1 0 1 0 r or sale.
intended r offered f I e (Se 70 44 ess and
c Busn'
Const. �63. 00
d a C ntrac r s L c n a a does n a an ner property who•
Co a Th0 to I a s Law of apply to owner of proper
builds
or improves thereon and who does such work himself of through his own employees,
-
Mech.
provided that such improvements are not intended of offered for sale if, however, the building
o; improvement is sold within one year of completion, the owner -builder will have the burden
Electrical
0 proving that he did not build or improve for the purpose of sale.)
0 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 Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
S. M. 1. 40
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
s. 0 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
tlX;Owner
Infrastructure
)`rte
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
0 Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL 65.40
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
0
(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 thp 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
ZONE: BY:
subject. to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply With such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback from Center Lin
Rear.Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
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.
Issued by: Date Permit
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-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant ---Date
Mailing Address
Validation:
City, State, Zi
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
~
BONDING
Y
ARD SPKLR SYSTEM
2ND FL. S0. FT. @
FORMS Al
SEWER OR SEPTIC TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
FOUND. REINF.
GAS (ROUGH)
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. @
GROUT
WALL SO. FT.
SERVICE
DRINKING FOUNTAIN
SO FT @
BOND BEAM
�v t
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
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, TEM/PERM
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
MESH
SO.FT.GAR @ 3/ac
HOUSE SEWER
INSULATION/SOUND
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 Al
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
�v t
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 3�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL