06949 (SFD)T4tyl 4 4 Q"
Building 49-126 Ulada Court
Address
BARCON DEVELOPMENT
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
mailing
Address 68-713 Perez Road, #1
Address
city Cathedral 1; 1 t_%1 Zip VZZ34 TeI71 3-9UZ4
Address
City Izio Tela
State Lic. ILity# �
& Classif. 337677
Arch., Engr.,
Designer
Address
City Zip State
Lic. #
,/' LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commenci�ig with Se tion
70(10) of Division 3 of thle�Business,and Professions Code,land my license is in,full,fqrce and
effect.
SIGNATURE Y•' J DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bustness and Professions Code: Any city or county which requires a
permit to construct, after, 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 provisions of the Contractor's 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
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a chd penalty of not more than five hundred dollars ($500).
❑ 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 inproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. N however, the building
or improvement is sold within one year of completion, the owner -builder wig 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.)
❑ I am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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 is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) vaketion
or less.)
1 certify that in the performance of thg work for which this permit is issued, I shall not
employ any penirson in any manner so as to become subject to the Workers' Compensation
Laws of Califora
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 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 if work thereunder is suspended for 180 days.
I certity 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
No. 06949
11LDING: TYPE CONST. OCC: GRP.
Tract 1#21555-5: Phase
P. Number
Legal Description
Project Description
PARC LA QUIRTA
Plain 1740 (E), Lot #24
Sq. Ft.
Size
New L
1,740 No.
Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimated Valuation
$88,574
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
s►yri•Z5
Const.
ZltlU • UU
Mech.
6th • 50
Electrical
i0z.m
Plumbing
50
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
3, ~ • Ob
REMARKS
r y
�,y �°
i�'Tt 3 14
y
.t�� n (3 , lK!
n73,
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
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE 2
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SQ. Ff. @
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. Fr. ®
ROCK STORAGE
FOUND. REINF.
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEOUIP.
DRAINAGE PIPING
CAR P. I SQ. FT. ®
S
TEMP. POLE
WALL SQ. FT. ®
DRINKING FOUNTAIN
WATER HEATER
URINAL
SQ FT. ®
BOND BEAM
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FRAMING s t� (A./
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL . FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
IKITCHEN 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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. Fr. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.Ff.GAR ® 3/ic
HOUSE SEWER
INSULATIONISOUND O
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 Z l �d
GROUND PLUMBING 21111?10,c/
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 2
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) S lS q0
G
�J 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. Z? d
FRAMING s t� (A./
FINAL INSP.
ROOFING
i _ l�/� /�
i,/ �q.0
( 7
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL)
Lae 0 Y0
MESH
INSULATIONISOUND O
FINISH GRADING
FINAL INSPECTION
C
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I