The URL can be used to link to this page

06786 (PLBG)Building Address 54-725 Pa uire2 Owner T4hf 4 4 " P.O. BOX 1504 NO. 78-105 CALLE ESTADO LAQUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP.; A.P. Number .• . • • 774-275-023 mailing Address 4240 Admirable Drive City Zip Tel. Rancho Pais 'Verdes 9027 231-377—q327.- Contractor 31-377-3327; • .. Contractor Address I 68-365 Perez Road 92234 ITeI. _ _ ... State Lic. I City & Classif. 410275 Lic. # Arch., Engr., Designer Address I Tel. CityIZip I State Lic. # fI LICENSED CONTRACTOR'S DECLARATION I hereby affimi'that I am licensed under,- provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and fessions Code,�and my license is in full force and effect. %,rl 7� '%rr ! (f, ) A' r 411SIGNATURE" O /.- ! .a'�"" DATE OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8ush ess 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 civil penalty of not more than rive hundred dollars ($500). ❑ 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, Suisness 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 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 acontractor(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 ff the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the 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: ff, after making this Certificate of Exemption you should become subject to the workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions o/ 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.) Lender's Name Lender's 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. 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 egal Description roject Description Sq. Ft. No. No. Dw. Size w . Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal.. Const. S30.00 Mech. Electrical FINAL DATE Plumbing Issued by: S.M.I. Validated by: Grading Validation: Driveway Enc. Infrastructure cn TOTAL 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 1/4/90 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES PLUMBING FEES 1ST FL. SQ. FT. $ UNITS ? r ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. ® FORMS / SE T K ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SQ. FT. ® FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN. WALL SQ. FT. =$ LUMBER GR. FINAL INSP. URINAL SO FT ® ROOFING ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FIREPLACE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11% c SEWAGE DISPOSAL SQ.FT.GAR @ V4c HOUSE SEWER CERT. OCC. 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 / SE T K ROUGH WIRING. DUCTWORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL _41 z 4. COACHELLA VALLEY WATER DISTRICT CASH RECEIPT DETAIL I- %% = ML2" Received From: I Address; Ala v -r% ' Account No.Milo\'3'10:Lot(s) AS-4---2 Service Add ' Met6r(s).,,. A 0 Semce( l3ackfloW Ryl*,#, '0,'Hou" _5 O _Check(ellr "0, Meter sure Sanitfal6r�Cipadftj,'PhiFpe - 0 W A F:r. O -Tem I porary Construction Meter -0 Turn on Charge - 0 Uncollected Account - Narrie 0 Inspection Fee -Tract - Fee - 0 Plan Check Fees Water I Sewer - Tract 0 Bond Payment A.D. --Bond Asernt. 0 Customer Deposit 'L 0 Other— Remarks: 0 COPY to: Cash' Check Money Order � 14% A V HMO I N2 26956 2.1 3 Tract— G.A. Code TOTAL _Z Water Service .Cash CVWD-438 (11189)