06944Building 49-3N gala" Court
Address
BARCON DEVEl.ORINT
Mailing 68-713 Perez Road. #1
Address
City Cathedral Ci UiP 9ZZ34 ITel. 71
Contractor
Address
Tela
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
State Lic. City
& Classif. 337077 1 Lic. # 12.19
Arch., Engr.,
Designer
Address Tel.
City Zip State
_ Lic. #
�LICENSED CONTRACTOR'S DECLARATION
eby affirm that 1 am licensed urMer provisions of Chapter 9 (commenc
of Division 3,'of the Business. and Professioris.Code„and mV license is
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buskiess and Prdessiars 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 pend to !ie 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 avrl penally of not more than live hundred dollars (E500).
❑ 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
Prolessions Code: The Conbadoes License Law does not apply to an owner of property who
builds or improves thereon aid who does such work herself or through his own employees,
provided that such improvements are not intended or offered for sale. d, 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 safe.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, Bmsaress and ~essi)ns Code: The Contractor's License Law
does not apply to an owner of property who braids or knproves 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
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 cormplated if tone pend is for one hundred dollars ($100) valuation
,or less.)
1 certify that in the performance of tltp 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: ll, after mald7g 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 tis pert shag 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
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 certify that I have read this application and state that the above information is correct.
1 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
urposesSignature of applicant - Date
Mailing Address
City, State, Zip
No. 06944
BUILDING: TYPE CONST,-ract C 53 sR hale -v
A.P. Number
Legal Description
Project Description
PARC LA QUIN'TA
Plan 2004 (C): Lot #15
Sq. Ft. 2,004 No. No. Dw.
Size Stories Units
New [% Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $102,026
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
545.95
Const.
650.00
Mech.
73.00
Electrical
113.30
Plumbing
138.50
S.M.I.
7.21
Grading
Driveway Enc.
Infrastructure
2.295.. 59
s
TOTAL
3,$.
REMARKS
4f1
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. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE Z l
v c./
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
FOR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO. Ff.
WALL SO. Ff.
DRINKING FOUNTAIN,
SERVICE
FINAL INSP.
URINAL
SO FT ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ —Plus—X$—=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. /iL (�v
t
FLOOR DRAIN
MECHANICAL FEES
ROOFING5 LYS
(
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
T I N t(l L 6 -
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
HOUSE SEWER
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 ItI(2 6
e W
GROUND PLUMBING Z Q
CJ UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE Z l
v c./
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) !—l/ b0 a
J !c l
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. /iL (�v
t
FRAMING y
FINAL INSP.
I
ROOFING5 LYS
(
R�
/4 T6 4)(--(/0/�
!
L,914
� Vf
( / `Z
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
T I N t(l L 6 -
MESH
INSULATIONISOUND
J/�Otv
(
FINISH GRADING
FINAL INSPECTION �j0 )
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
`
GARDEN WALL FINAL
t