9797 (BLCK)dU P.O. BOX 15049797
Building 7&105 CALLE ESTADO �O
Address 53880 Ramirez LA QUINTA, CALIFORNIA 92253
Owner
Joseph Williams
Mailin
Address 10501 Wilshire Bird #1605
City Zip Tel.
L.A. 90024
Dennis Ric
74624 Drift -wood 04
City Zip Tel.:
Palm Desert 92260 346-1302
State Lic. City
&Classif. 453778 Lic.# 811
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S`DECLARATION
1 hereby affirm that I am licensed under piovislons of Chapter 9 (commencing with Section
700pf of Division 3 of the Business andrPrrofessions Code, and my license is in full force and
OWNER -BUILDER DECLARATION q
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buslness and Professions Code: Any city or county which requires a -
permit to construct, atter, 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 hundreddollars ($500).
O 1, 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 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
onstruct 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
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) valuation
or less.) / 1 %'
I certify that In the performance of tha work for which this permit is issued, I shall not
employ any person In any manner so as'to tiecome subject to the Workeis"Compensation .
Laws of California.
'Date Owner
NOTICE TO APPLICANT: If, gaffer "making this Certificate of Exerription 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
Ihereby 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.
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.
Signature of applicant Date
Mailing Address
City, State, Zip
LDING: TYPE CONST.OCC: GRP.
Number
I Desrrintion Lot li Block 236
Project Description
70 1f of 5' block ret wall
Validation:
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
TOTAL
45.20
'REMARKS
1i -; A -A 31 "'7 A -n M
45 20
Estimated Valuation
1805. 00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
45.00
Mech.
Electrical
Plumbing
S.M.I.
.20
Grading
Driveway Enc.
Infrastructure
Validation:
TOTAL
45.20
'REMARKS
1i -; A -A 31 "'7 A -n M
45 20
ZONE: BY:
Minimum Setback Distances:
Front. Setback from Center Line
V
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. PLUMBISJG FEES '
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. S0. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ.FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
GAS (ROUGH)
DRINKING FOUNTAIN.
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
plus x$
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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
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 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.
FRAMING
FINAL INSP.
ROOFING
7//,/0//
%
//�3
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL