Loading...
14406 (PLBG)Y44 Q N P.O. BOX 1504 S Building 78-495 CALLE TAMPICO - Address 53-120 Ave. Ramirez LA QUINTA, CALIFORNIA 92253 Owner Mr. & Mrs. Victor tor Broin. Mailing BUILDING: TYPE CONST: OCC: GRP. Address Saw City Zip Tel. La Qulntao � 92253. Co tractor oer Engineering a Construction . AdTOSss175. Banos Court Cityathedra1 i f -T CA 9223 Tet619) 327-220( State Lic.City & Classif. _ A.B 684563Lic. # Arch.; Er' gr., Designer Address Tel. City Zip State Lic. # �` {9 LICENSED • CONTRACTORS DECLARATION. I hereby affirm that I am,ll'censed under provisions of Chapter 9 (commencing with Section 7000) ofD`iVision 3 bf the'Business and ProfessPons Code, andV7 license is in full force'and —OWNER -BUILDER DECLARATION f. I hereby of irm that I am exempt from the Contractors 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 cMI penalty of not more than rive hundred dollars ($500).' 0 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 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 or Improvement is sold within one year of completion, the owner -builder will have the burden of provingthat he did not bulid 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 Ltcense,Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) Qcensed pursuant to the Contractor's License Law.) - - O 1 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 - Company rbopy 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 ($100) . valuation 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: N; after makbrg this Certificate of Exemption you .should become subject to the Workers' Comperisation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGEISUNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES -UP TO ONE HUNDRED THOUSAND DOLLARS ($110,000), IN ADDITION TOTHE COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN -SECTION 3706 OF -THE LABOR CODE, INTEREST. AND ATTORNEY'S FEES. This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 160 days. I 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. Signature of applicant Date Mailing Address City, State, Zip A.P. Number egal Description Sever Connect roject Description ZONE:' Sq. Ft. Size No. Stories - No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ r -X Estimated Valuation .$1,474.00 PERMIT AMOUNT 'Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical 1 In 10-k Ift Plumbing- S.M.I. Grading Driveway Enc. Infrastructure TOTAL 3 ©. U-0 .REMARKS 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 �Pe�mit r, 1! n ULl Validated by: ' I I. n II Validation: �I IIF(' 1 4 1QQA CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SQ. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SO. 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER '� / GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPIEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® IIA c SEWAGE DISPOSAL ///` SQ.FT.GAR ® 3/ac HOUSE SEWER VENTILATION GAS PIPING PERMIT FEE FIRE ZONE ROOFING 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 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 ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEOUIP. 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. FRAMING FINAL INSP. ROOFING ///` REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESIINITIALS GARDEN WALL FINAL