06090 (BLCK)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 49-455 Coachella LA QUINTA, CALIFORNIA 92253
Mailin
Address
Contractor
DeWitte Const., Iztc.
No.
BUILDING: TYPE CONST. OCC. GRP
A.P. Number - 617-x680-005
Legal Description
Project Description 61 block retaining "ll 160' long
-- 75-145 St. axarles P1.
City
Zip Tel.
Palls Desert
192260 773-4764
State Lic. City
& Classif. 423012 iC. #
Sq. Ft.
No. No. Dw.
Arch., Engr.,
Designer '
Size
Stories' Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
hereby affirm that I am licensed under provisions of Chapter'9 (commencing with Section
Di
7000) of vision 3 of the Business and Professions Code,-,anddmy license is in full force and
effect
SIGNATURE - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
�reatsorr (Sec. 7031.5,Busiress and Professions Code: Any city or county which requires a
pemmit fo arrstrrrct atter. 'improve, demolish, or repair any structure, prior to its issuance also
}regliros the appticart for such permit to fie a signed statement that he is licensed pursuant to
- the Provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
0llision 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 al>pilicard to a civil penally of not more than five hundred dollars (5500).
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, 8uisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
buiAYs or improves thereon and who does such work himself or through his own employees,
provided that such irprovements are not intended or offered for sale. if, however, the building
or irprovem�ent is sold within one year of completion, the owner -builder will have the burden
of provig that he old not build or improve for the purpose of sale.)
Estimated Valuation
$4,000
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
63.U(t
Mech.
Electrical
Plumbing
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
stmt the project (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not appy 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
S.M.I.
n
.28
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent.to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof.i(Sec. 3800. Labor Code.)
Policy No- -- Company `� •'l/4r /
!1
❑ Copy is filed with the city. O Certified copy isheieby furnished.
" �" f 7
TOTAL
$63.28
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-)
I certify that in the performance of the work for which this permit is issued, I shall not
employ arty person in any manner so as to become subject to the Workers' Compensation
Laws of California.
REMARKS
I is
cy r1 1 s!i!.>�� } 4�4 i 't� .1 -�y 4SJ • 28 1 �1
Date Owner
NOTICE TO APPLICANT: ff. after making this Certificate of Exemption you should become
subject to the Wlwlrers' compensation provisions of the Labor Code, you must forthwith
carptyathsuch Provisions orthisPermitshallbedeemedrevoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lenders Name
Lenders oddness
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.
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.
FINAL DATE
Issued by:
Validated by:
ECOR
IN P/T
7PEC O
/
Date Permit
Signature of applicant Date
Mailing Add rn ss
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEEL
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB,
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. Ff. 0
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING,
MOBILEHOME SVC.
BAR SINK
POR. Sp, FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. Fr. ®
POWER OUTLET
ROOF DRAINS
00,
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. Sp. Ff. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
BOND BEAM —7sc �
ER SYSTEM
URINAL
SQ FT ®
_$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
- WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SQ. Fr. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. Fr. RESID ® 1% 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. `1 ��J
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
00,
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM —7sc �
ER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
�A74�
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