04298 (BLCK)Building 51-300 Ramirez
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA,.CALIFORNIA 92253
Owner I
€ eret Homes # Ltd.
Mailing
Address 7220 Trade St., 0.100
City Zip Tel—
San Diego 1 93121. 1 0��'��.��� �....
Contractor
Landel Corn.
WILDING: TYPE CONST. OCC. GRP.
k.P..Number. 773-083-003
^egal Description
)roject Description Retininq Wall
Sante
City
Zip
Tel:
State Lic.
& Classif. 330551
City
Lic. # 8t�9
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
I hereby affirm that I am licensed under provisions of'Chapter 9 (commencing with Section
7000) of Division 3 of the Business and. Professions Code, and my license is in -full force and
effect. d J
- �.'J
SIGNATURE' s DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
�q
. reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
PERMIT
.
AMOUNT
permit to construct, alter, 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 civil 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
Plan Chk. Dep.
Plan Chk. Bal.
Const.
•
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
Mech.
builds or improves 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.
Electrical
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.)
Plumbing
❑ 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
S.M.I.
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
Grading
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 is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
s1wt.� v 4 rSik1 'e 1 r r;r'i--,y M � P,; !�e It
(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 Ing work for which, this permit is issued, I shall not
a. W�rK2< w ♦4<�)tn i,.,7
employ any person in any manner so as to become subject to themorkers' Compensation
Laws of -California.,•'
Date ` r= o°Owner
NOTICE TO APPLICANT: df, after making'this Certificate ofExemptionJyou should become
subject to the Workers' Compensation provisions.of the. Labor Code, you must forthwitA
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side, Setback from Property Line
Lender's Name
Lender's Address
This is a building; permit when properly filled out, signed and validated, and is subject to7/11/'189
expiration if work thereunder is suspended for 180 days.
FINAL DATE
-INSPECTOR
y / Q q j•
s 0 8 3 d
1 certify 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.
. Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
GOLDENROD ASSESSOR S OFFICE HARD COPY -FILE
City, State, Zip
WHITE FINANCE PINK APPLICANT GREEN BUILDING,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT y $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. a
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FTa
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GARSO. FT.
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO FT. Ig
FINAL INSP.
LrAlIBOND BEAM ��� ^
WATER SYSTEM
DRINKING FOUNTAIN
WALL SO. FT. (d
_$
LUMBER GR.
FINAL INSP.
URINAL
SO. FT. (d
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
I
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTOXDISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN 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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID g 1'A c
SEWAGE DISPOSAL
SO.FT.GAR Ai<c
HOUSE SEWER
CERT. OCG
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 8 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.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
LrAlIBOND BEAM ��� ^
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCG
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIAlS
GARDEN WALL FINAL