003306 (BLCK)ot
P.O. BOX 1504 No-. 003306
Building 78-105 CALLE ESTADO
Address 78-660 SAGUARO LA QUINTA, CALIFORNIA 92253
Owner
RICK JOWSON CONSTRUC:'IOs�
Mailing
Address Pace BOX 929
CityZip T
el.
LA' Q A 92253 -
Contractor
RICK JORNSON CONSTRUCTION .
.Address
BUILDING: TYPE CONST. -OCC: GRP.
A.P. Number
Legal Description Wig' 85
Project Description
" City-
Zip
Tela
State Lic.
City
ZONE:
& Classif. 397169 B
Lic. # 202
Sq. Ft., No.
Size Stories
No. Dw.
Units
Arch:, Engr.,--
Designer
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Address
Tel.
Side Setback from.Property,Line
FINAL DATE
INSPECTOR
Issued by:.
CityZip
Validated by:
State
-
Lic. #
. _ LICENSED CONTRACTOR'S..DECLARATION
ATION
I hereby affirm that I am licensed under provisions of Chapter 9'(commencing with Section
7000)_.6of-Division 3 of the Business and Professions Code, and my license is in full force and
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, 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 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 ($500).
• ❑ I, as owner of the property, or my employees with wages as their sole compensation, will
Estimated. Valuation
PERMIT., -
A. '
AMOUNT '
Plan Chk. Dep.'
,
Plan Chk.. Bal.
Const.
2� ,
ra '
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.)
Mech.
EI2CtrICal
Plumbing
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
S.M.I.
_
`
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 No. Company -
0 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 ($100) 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 California.
Date Owner
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or the Labor Code, 'you must forthwith
comply with such provisions or this permit shall 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, Civil Code.)
Lender's Name
Lender's Address
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,
ddress City, State, Zip
HARD COPY
Infrastructure
TOTAL
REMARKS
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
Issued by:.
Date A110!87 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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
LATHING
MESH
INSULATIONISOUND
NISH GRADING
AL INSPECTION !,
CERT. OCC.
FENCE FINAL
IN,1'tG I V K'b WUNA 1 UHLb/INl 1 IALJ,
GARDEN WALL FINAL