14846 (SFD)Building
Address
Owner
Y414Q
P.O. BOX 1504
No. 14846
78-495 CALLE TAMPICO
45-120 Ramblewood Ct. LA OUINTA, CALIFORNIA 92253
Inco Homes
Mailing ^
Address 250 R.. Rincon. Ste. 202
City Zip Tel.
Corona, CA91719 1(909)736-0700
Contractor
Same
I TeL
State Lic. City
& Classif. g $23968 Lic. # 3318 '
Arch.; Engr., C. ori.
Designer
121 ` e.,gel
at De La Guerra (T805) 9b2--4575
City Zip State
Santa 'Rarbara $ ' CFP 93101' Lic. # - 0.1.2850
LICENSED CONTRACTOR'S DECLARATION .
I hereby affirm that I am licensed under provisions of Chapter.9 (commencing with Section
of Division of tfie Business and Professions Code, and my license.is in full force and
1_SLGNATURE � �Y ;,J DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any. _clfy, or county which requires a
permit to construct, after, improve, demolish, or repair any structure; prior to itsissuance also
requires the applicant for such permit to rile 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 five hundred dollars (8500).
O 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
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 a contractors) #caned 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.)
=Poli o. 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 if the permit is for one hundred dollars (8100) valuation
or less.)
I certify that in the performance of thg 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 Cali foru
nia.
Date Owner
NOTICE TO APPLICANT: N, after making this Certificate of Exemption you should become
subject to the Workers' Compensatton 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, ordinancesand 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
BUILDING-. TYPE -CONST. OCC. GRP,
A.P. Number
R3
Legal Description 7,ot 20 Frac:, 23995- 1
Project Description. SFD 'Plan
Reunio a at La ,-QUy nta
REMARKS
ZONE: :BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from RPerty
Line
Side Street Setback Line
Side Setback fro
FINAL DATE
Issued by:
Validated by:
Validation:
Sq. Ft. 2008
Size.
No. No. Dw.
Stories - Units -
New ❑ Add ❑ -
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$120r912.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
594.65 _
Const.
_ 713.90
Mech.
55.50
Electrical
145.90
Plumbing
138.00
S.M.I.
12.09
Grading
Driveway Enc.
.00-
Infrastructure
2 r 1 20.52
Arts in Pu
T16 Places 52.28.
TOTAL
4,451.94 .
REMARKS
ZONE: :BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from RPerty
Line
Side Street Setback Line
Side Setback fro
FINAL DATE
Issued by:
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. ® $
UNITS
A.C. UNIT
2ND FL. SO. FT.
SLAB GRADE 1
YARD SPKLR SYSTEM
]
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
STORAGE TANK
FORMS'
GAR. ] SO. FT. ®
POWER OUTLET
ROOF DRAINS
ROUGH WIRING
DUCT WORK
DRAINAGE PIPING
CAR P. + S0. FT.
]
WALL ? SO. FT. ®
GAS (ROUGH)mnj \
! JJ
DRINKING FOUNTAIN.
} SO. FT.
OTHER APPJEOUIP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
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
BOND BEAM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
WATER SYSTEM
FINAL INSP.
LAUNDRYTRAY
AIR HANDLING UNIT ] CFM
=$
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR I HP
POLE, TEM/PERM
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/a c
SEWAGE DISPOSAL
'
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE ]
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
e
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
I
STRUCTURE I PLUMBING #LECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 1
ROUGH PLUMB. 11V
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS'
SEWER OR SA
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
44
]
GAS (ROUGH)mnj \
! JJ
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP. %�J
f
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
ROOFING "
VENTILATION (
ryz
Vf
f
r
��/���
of
y O ' '
(, J
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR 1
GAR. FIREW LL j
LATHING
MESH
INSULATIONISOUND !l`,
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL