14600 (PLBG)Building
Address 54-510 . Ave • Rubio
Owner Raul. Vega
Mailing Same
Address
City Zip Tel.
La Quinta, .CA4 9225..E
Contractor
All Plumbing
Address
551 industrial Place
+ y Zip
Pa'lm Springs, ICA
State Lic.
& Classif. C_36 521960
Arch., Engr.,
Designer
Address
P.O. BOX 1504 NO. 1 4 b iJV
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
1
BUILDING: TYPE C6N8T!1 OCC: GRP..--,-
A.P.
RP. A.P. Number
Legal Description
Project Description Sever Connect
92264 Tel -`322-0 673
City
Lic. #
Tel.
Sq. Ft. No. No. Dw.
Size- Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition
City
Zip
State
Lic. #
_ LICENSED CONTR CTOR'S DECLARATION
1 hereby affirm`thst Lam liyens€�under�p/rovWons of Chap1ar 9 (commencing with Section
7000) of ivision of the Business an rProfes�slionsLGrsde-Snd my license is in full force and
'r
SIGNATURE DATE
-
OWNEWBUILDER DECLARATION
I hereby I from for.
Estimated Valuation
i500-00
affirm that am exempt the Contractor's License. Law the following
reason: (Sec. 7031.5,Business and Professions Code: Any. city or county, which requires a -
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 statement that he is licensed pursuant to.
PERMIT AMOUNT
- the provisions of the Contractor's License Law, Chapter 9 (commencingwith•Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
- for the Any Section 7031.5 by 'any for
Plan Chk. Dep.
alleged exemption. violation of applicant .a permit
. • 'subjects the applicant to 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 sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.
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,
Mech.
. 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
Electrical
of proving that he did not build or inprove for the purpose of sale.) .. .
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing 30.00
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.
such projects with a contractors) 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, ora certified copy thereof. (Sec. 3800; Labor Code.).
PoI Company
L-iCopy is filed with the city. ❑ Certified copy is hereby furnished.. •
3*
TOTAL 30 *10'0
CERTIFICATE OF EXEMPTION FROM
REMARKS
• WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (S 100) valuation
'S
' 'or less.)
-
I certify that in the performance of thg work for which this permit is issued, I shall not •
fR , f -
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of alifornia
California-
_
Da
NOTICE TO APPLICANT:r ff, 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
- Side Street Setback from Center.Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN 'SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when property filled out, signed and validated, and is subject to
FINAL DATE INSPECTOR
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.
Issued by: Date Permit
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.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT. ®
POR. SO. FT.®
GAR. SO. FT. ®
CAR P. SO. FT. ®
WALL SQ. FT. ®
SQ. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) (
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
I
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
I
( ,
SQ.FT.GAR ® VAc
HOUSE SEWER
VENTILATION
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
i
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
C
SEWE ORS� _y 4-15
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) (
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) !
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_ $
LUMBER GR.
I
FINAL INSP.
FRAMING
FINAL INSP. / 3/ 7S
ROOFING
I
( ,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
r, ha
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESJINITIALS
GARDEN WALL FINAL
OF-pop,
>r
=r
v,
Received F
Address:
Account N
Service At
❑ Meter(s)
❑ Service(s)
❑ Backflow(s)
❑ House Lateral(s)
❑ Detector Check(s)
❑ Meter Surcharge
anitalion Capacity Charge
❑ W.S.B.F.C. .
❑ Temporary Construction Meter
❑ Turn on Charge
❑ Uncollected Account - Name
❑ inspection Fee -Tract -
Fee -
❑ Plan Check Fees Water 1 Sewer -
Tract -
❑ Bond Payment - A.D. -
Bond----
Assmt.
❑ Customer Deposit
❑ Other
COACHELLA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL A 1
TOTAL
Remarks:
G
❑Copy to: Water Service
Cashier f %�
Check r✓ ( I / ti'r„<•
% CVWD-438 (11189) .
Money
Order