003718 (RPL)Building
Address 553-800 Rubio
Owner
Mailing
Address
City
Perez
Zip
T:Fa'-X3t -. I- 53ZI�.
Contractor
11S38Ztake Poola
Address.
P.O. BOX 1504
78-105 CALLE ESTADO
-LA QUINTA, CALIFORNIA 92253
No. 003718
` BUILDING: TYPE CONST. OCC. GRP.
. F A.P. Number 774-153-004-005.
Tel.
Legal Description
Project Description���
P. 0. Bok 835
City. ...
Zip
Tel..
1' 3,*t Desert
32261
568-4014
State Lic.
City
& Classif. 372
Lic. # aa:3
Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer,
New ❑ . Add ❑ Alter ❑' Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. # '
• /LICENSED CONTRACTOR'S, DECLARATION
r
I hereby affirm,that;l am Jicensed urider provisions of Chapter 9 (commencing with Section
7000) of Division 3 of lhe,Business-arid Professions Code, and my license is in full force and
effect. t. j jj4 I *"• l JiS
SIGNAT R *1' %W DATE
411 • ,• OWNER•BUER DECLARATION
Estimated Valuation „•
I hereby affirm that I am exempt from the Contractor's License Law for the following
Any
• _reason: (Sec. 7031.5,Business and Professions Code: city or county, .which requires'a
permit to construct, atter, improve, demolish, or repair any structure, prior to 4ts issuance also-
- requires the applicant for. such permit to file a signed statement that he is licensed pursuant to
F, _
PERMIT AMOUNT -
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000), of
.rr
' Di0slon 3'o/ the Business and' Professions Code, or thathe is exempt therefrom, and the basis
for the Any Section 7031.5 'any for
Plan Cflk. Dep. $44.52
alleged exemption. violation of by applicant a permit
subjects the applicant lo'a civil penalty of not more than five hundred dollars ($500). '
Plan Chk. Bal.
O I, as owner of the property, or my employees, with -wages as their compensation,, will.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const. 168.50Professions
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.. 20.00
.. 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 willhave the burden
Electrical- 00
., 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 - 15 . P11
• 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.L:
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
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 js hereby.furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed , it the. permit is for one hundred dollars ($100) valuation
'
or less.) .. -er / d'
I certify that in the performance of thg work for which this permit is issued, I shall notl!`��•�'
li0"iC'"iSfx l�
employ an y person in anyanner� as lo,bec subject the Workers' Compensation
Laws of California.
i
'
Date / � iOwnei� >�%'`�✓ ."'!"�� :'4
NOTICE TO APPLICANK''ll7bter making'thls Certificate 6f -Exemption youtshould become
subject to the Workers'�`Compensation'provisions of the Labor Code,you must forthwith
ZONE: BY:
comply with such provisions or this permit shall be deemed revoked. -�► /-
Minimum Setback Distances: - - '
Front.Setback from Center Line
•
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
Ihereby 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 if work thereunder is suspended for 180 days.
I that I have
certify read this application and state that the above information is correct.
agree to comply
Issued by: °—Date 1 .Slermlt
with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
r
mentioned property for inspection purposes.
Validated by:
Signature of applicant . Date
Mailing Address
Validation:
City, State, Zip "
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES ,
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. a
POR. 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
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WAL:_ FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE,
SMI FEEPLUMB. 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
CJ U~G/�
REMARKS:
VENTILATION!/26
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