06945 (SFD)T4t!t °F 4 Q"
Building
Address 49-275 8alada Court
Owner
0ARCOH 4CYEt
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address 68-713 Perez Road, 01
City Cathedral C49p 92234 JTJ 773-9024
Contractor
City
State Lic. City
& Classif. 337477Lic. # 1219
Arch., Engr.,
Designer
Address Tel.
City (Zip (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affimrthat 1 am licensed under provisions of Chapter 9 (commencing with Section'
7M,W Division 3�ooff the Business and Professions Coddelaand my license is�in/full force and, -
SIGNATURE DATE
OWNEWBUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Bushess and Professions Code: Any city or county which requires a
pemlit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such pem* 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 crvi penalty of not more than rove 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 rmproves thereon and who does such work himself or through his own employees,
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
of proving that he did not build or improve for the purpose of sale.)
O 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.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. 0 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 (5100) valuation
or less.)
I certify that in the performance of thg 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 ff, 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 isa construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders 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 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. 06945
ILDING: TYPE CONST. OCC. GRP.
I. Number Tract #21555-54 Phase V
Description
Project Description
PAP -r- LA Quit=
Pian 1620 (A).
Lot 016
Sq. Ft. 1 ,520
Size
No.
Stories
No. Dw.
Units
New WX Add ❑ Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$84.822
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
4W.68
Const.
5 2.OU
Mech.
66.50
Electrical
99.80
Plumbing
124.50
S.M.I.
5.95
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
,.> < �, r.•. r ,•
fU`'''Ckli
t`TIOAL i
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 SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE 2, 9
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
I
GAS (ROUGH)5///h., C n
METER LOOP
DRAINAGE PIPING
CAR P. SQ. FT.
REINF. STEEL
WALL SQ. FT. ®
TEMP. POLE
DRINKING FOUNTAIN
URINAL
SQ FT ®
WATER HEATER
SERVICE
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
/
FRAMING / /0 cli
t ((( Z
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROOFING
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® Vhc
HOUSE SEWER
`f P7
GAS PIPING
PERMIT FEE
Il 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 2 Q
F �`f
GROUND PLUMBINGZ B
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 2, 9
e (J
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)5///h., C n
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.
FINAL INSP. 4 113h W
/
FRAMING / /0 cli
t ((( Z
FINAL INSP.
ROOFING
, ,/)
Li
T 49r
Y" (
�
(�
REMARKS.
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
`f P7
MESH
INSULATION/SOUND �v C
FINISH GRADING
FINAL INSPECTION ,1S 0
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL