14288 (BLCK)79-165 Bighorn Trail
Building
Address Minisrelli Construction
Owner
Ministrelli Construction
Mailing
Address 50-445 Mountain Shadows
City lZip Tel.
Contractor
of 44F GQ"'o "
P.O. BOX 1504 N o. Cf
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
BUILDING:. TYPt CONST. OCC. GRP
A.P. Number
Legal Description
Project Description 903.E of 6' garden wall
Aaaress
City Zip Tel.
State Lic. City
& Classif. 5 0 5 Lic. # 4 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
hereby affirm that I am,licerised -under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the`Business and Professions Code, and myi'icense is in full force and
. -/effect. / j �'• ,r ✓�,.rr' `
` `.^
IGNATURE -' DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
Estimated Valuation
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 file a signed statement that he is licensed pursuant to
PERMIT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Plan Chk. Dep.
Division 3 of the Business and Professions Code, or thathe 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 or not more than five hundred dollars ($500).
D 1, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
Const.
Mech.
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
Electrical
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
C I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
• S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
I am exempt under Sec. B. & P.C. for this reason
Grading
Driveway Enc.
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800. Labor Code.)
Policy Company
opy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE /
(This section need not be completed if the permit is fortune hundred dollars ($f00)J'valuation
or less.) ./ /• f%^ / e
I certify that in;the pertormance,of thV 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 4 Ko
Date -y= Owner
NOTICE TO APPLICANT., If, after making" this Certificate of Exemption you should become
subject j% the Workers' Compensation 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 COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE 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 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
Infrastructure
$2250.00
AMOUNT
3%.V VI
TOTAL I I J'* ' VV
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center
Rear Setback from Rear ��
Side Street Setback from<C
Side Setback from pert,
FINAL DATE IN�PECTO
Issued by:_
Validated by:
Validation:
Date
I CONSTRUCTION ESTIMATE I NO. ' ELECTRICAL FEES I NO. I PLt1MBINii FEES
1ST FL. SO. FT. @ $
UNITS
GROUND PLUMBING
2ND FL. SO. FT. ®
A.C. UNIT
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT. @
DRAINAGE PIPING
WALL SO. FT. @ _
DUCT WORK
DRINKING FOUNTAIN
SO. FT. @
URINAL
ESTIMATED CONSTRUCTION VALUATION $
HEATING (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GRADING
cu. yd.
$ plus x$
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 @ 1% c
SEWAGE DISPOSAL
FIRE ZONE ROOFING
SO.FT.GAR ® 3Ac
HOUSE SEWER
FIREPLACE
GAS PIPING
PERMIT FEE
SPARK ARRESTOR
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE LPLCK.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$
c$
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.
ENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL