11045 (RPL)Building
e rtri.noc 54_190. Ramirez
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner I
John Dincess
Address Flame
cityr a Qtxiata zip 92253
Contractor
Majestic Water Treads
Address
42446 Bob Hope Dr.
city zip
No. 11®45
LDING: TYPE CONST. OCC: GRP,
P. Number
el.
564-2379 Legal Description
41 --
Project Description
State Lic. City
& Classif. C53 560471 Lic. # 1428 Sg. Ft.
Arch., Engr.,
Sie
Designer New ❑
Fooi arta bpa
No. No. Dw.
Stories - Units
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.
7000yof"Division 3 of the Business and Professions Code, and my license is in full force and
/reffact..''
MATURE - _ DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
1 hereby affirm that I am exempt from the Contractors License Law for the following
.12 000
. reason: (Sec. 7031.5,Business and Professions Code: Any city or County which requires a
,
Permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statementthat he is licensed pursuant to
-
PERMIT - AMOUNT
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 Any Section 7031.5'any for 'permit -
-
Plan Cflk. Dep.
alleged exemption. violation of by applicant a
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
- ..
Plan Chk. Bal. 87.75
_ ❑ 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-
Const. 5
Professions Code: The Contractor's License Law does not apply to an owner of property who
.00
builds or Improves thereon and who does such work himself or, through his own employees,.
r `a
Mech.. Z d
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
e
Electrical 1 ` 45
. of proving that he did not buildor improve for the purpose of sale.) ..
.00
' ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing 7 Q
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. 1
such projects with a contractor(s) licensed pursuant to the Contractor's License Law:) -
.20
Grading
O I am exempt under Sec. B. 8 P.C. for this reason
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
Workers Compensation Insurance, or a.certified copy thereof. (Sec. 3800, Labor Code.)
Poliq No. Company
K }F $' tea 4� AI^tilrf -r-111 ?��� t r"
r3
O Copy is filed with the city. ❑ Certified copy is hereby furnished.'
3 r3
TOTAL 31 T, 95
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation -
'- orless.) '
I certify that in the performance of the work for which this permit is issued, I shall not
=any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of tie Labor' Code, you must forthwith
comply with such provisions or this permit shall 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.)
Lenders 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. .
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
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. I PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
ROUGH WIRING.
DRAINAGE PIPING
WALL SO. FT.
FOUND. REINF
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
OTHER APPJEOUIP.
WATER PIPING
NOTE: Not to be used as property tax valuation
GAS (FINAL)
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SERVICE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
BOND BEAM
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR Hp
POLE, TEWPERM
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 ® 1% c
SEWAGE DISPOSAL
FIRE ZONE ROOFING
SO.FT.GAR ® 3/ic
HOUSE SEWER
FIREPLACE
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
IL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING S AIR COND. SOLAR
SETBACK
GROUND PLUMBING1
10UNDERGROUND& l7 Z(
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
FINAL INSP. $ Gra
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
FINAL INSP. rQ r9/t
ROOFING
/y
�J
REMARKS:
VENTILATIONG�
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOWS SIGNATURESIINITIALS
GARDEN WALL FINAL