06796 (GRES)P.O. BOX 1504 No.
Building 78-105 CALLE ESADO
Address 49-797 Coachella LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 2951 1
Cit
ulmttes Ill
Contractor
Craig
Address
Zip Te
619091
i.13Y11 aln CC327i an
73-612 Highway 111 #7
City Zip TeL
Palm Desert 92260 346
State Lic. City
& Classif. 3161634 Lic. #
' 'Arch., Engr.,
Designer
Address Tel.
{: 06796
BUILDING:' TYPE CONST. OCC: GRP.
A.P. Number
I.
20.8--251.'-88$1 Legal Description
Project Description Garage- eatto,->asinn
CityIZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION'
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bvshss and Professions Code: Any city or county which requires a
permit to construct, after, irprove, demolish, or repair any structure, prior to Its issuance also
requires the applicant for such permit to We 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 exenptionn. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penally of not more than five hundred dollars (8500).
❑ 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, Suisness and
Professions Code: The Conhadors License Law does not apply to an owner of property who
builds or inproves thereon and who does such work hanself or through his own employees,
provided that' such irprovements are not intended or offered for We. If, however, the building
1 or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or irpove for the purpose of safe.) .
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
s
truct the project (Sec. 7044, Business and Professions Code: The Contractor's sLicense Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a,contrAdor(s) icensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec- a, & P.C.-for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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.
'r
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be carpAeted ff the permit is for one hundred dollars ($100) valuation
or less.) '
I certify that in the performance of thg work for which this permit is issued, I shall not
=any ppeerson in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANr: ft, after miftg this Cerlilicate of Exemption you should become
subject to the ftrivers' Cerrpmsatbn provisions of the Labor Code, you must forthwith
comply with such provisions or this Permit shag 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, CW Code.)
Lenders 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
Sq. Ft. 24 No. No. Dw.
Size Stories Units
New ❑ Add ❑
Alter ❑
Repair ❑ 'Demolition ❑
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
Ip/94
Issued by:
mated Valuation
1�t
$4,152
PERMIT
Validation:
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
R
MAR
Const.
72.00
Mech.
Electrical
Plumbing
S.M.I.'
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS._
.. V
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
Ip/94
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN.
BOND BEAM
WATER SYSTEM
URINAL
SO 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
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ®bbC
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
OBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
1
SMI FEE PLUMB. FEE
1 t
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 0%
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
//�1
LATHING Ott) 74
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
)