The URL can be used to link to this page

001917 (MISC)P.O. BOX 1504 �,+ No. fj()1917 Building 78-105 CALLE ESTADO Address 50-925 Calle F Indo LA QUINTA, CALIFORNIA 92253 - Owner Mailing hnA "h arra r' ° BUILDING: TYPE CONST. OCC: GRP.- - Address Sral� A_ ..P. Number 769'0705 City Zip Tel. Lot 31 Ja CXR. _ ... Legal Description 14 Contractor Project Description �►x�ex/��,3Lr ..Address. _ City' Zip. Tela . State Lic. City & Classif.. Lic. # Sq. Ft. No. No. Dw. Size a • 1- - Stories' -Units Arch:; Engr.; . . Designer . _ New Add ❑ Alter ❑ Repair ❑: Demolition ❑ Address Tel. City Zip State Lic. # - . LICENSED CONTRACTORS DECLARATION 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 ,-, _ . • . -, f _ _ _ OWNER•BUILDER DECLARATION Estimated Valuation I hereby.affirm that I am exempt from the Contractor's License Law for the following' c�'ry pn reason: .(Sec. 7031.5,Business. and Professions Code; Any city or county. which _ requires a ., �r r il•tT:f permit to construct, alterimprove, demoish, or repair any structure, prior to its issuance.also vequires_the applicant for'such permit to file a signed statement that he Is* licensed pursuant to PERMIT AMOUNT- the provisions .of the Contractor's License Law, Chapter. 9 (commencing :with Section .7000) of - DivisibW-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 P16 Chk. DOp:. - - subjects-the applicant to a civil penalty of not more than live hundred dollars ($500).. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 2• a� do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and. COr1St. ' 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; MetSh. 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 Electrical- 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- 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. •Ja/ - suchProjects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O I am exempt under Sec. - 8. &. P.C. for this reason ... i Driveway Eno, Date) f; F 71t Owner X + r i • %► Infrastructure WORKERS' COMPENSATION DECLARATION Ihereby 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 p Copy, is filed with the city. ❑ Certified copy is hereby furnished. TOTAL $3.02 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation - - - or less.) .. _ .. . 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: If, after making this, Certificate of Exemption you should become ZONE: - BY: `subject to the Workers' Compensation provisions of* the Labor' Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. - - Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from. Center Line "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.). Side Setback from Property Line Lender's .Name Lenders Address FINAL DATE INSPECTOR 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. Issued by: Date 12. 3--8.5 Permit agree to comply with'all'cityand 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. Validated by: Signature of applicant V\ + t } i t t bate => �• 'Mailing Address A- ' Validation: City, State, Zip - A3491 12 6 83.&2 R HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ® BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. ® OTHER APP.IEQUIP. DRINKING FOUNTAIN SQ. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER HEATER SERVICE FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM GRADING cu. yd. $ plus x$ _$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 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,TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ.'FT. ® c BATH TUB GAR. FIREWALL SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/4 c SEWAGE DISPOSAL MESH SQ.FT.GAR ® 3/ac HOUSE SEWER INSULATION/SOUND GAS PIPING PERMIT FEE FINISH GRADING 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. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. Ij REINF. STEEL V 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 SIGNATURES/INITIALS. GARDEN WALL FINAL