15034 (BLCK)P.O. BOX 1504 N o . 15034.
Buildirig 78-495 CALLE TAMPICO
Address 5 40 Calle Paloma LA QUINTA, CALIFORNIA 92253
Owner Sterling Rowes
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address P.O. Box 450
A.P. Number
City Zip Tel.
Q
i, a (�uint8y Chi .92253 564 Legal Description
ContractorI5' of 5 ° high garden block
��t��d6l Ventures, Inc. Project Description
IS
same
City Zip Tel.:
State Lic.13 City
& Classif. 6335 Lic. # $�� Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSE CONTRACTOR'S DECLARATION
I hereby affirm that I am licensgd under provisions of Chapter 9 (commencing with Section
7000)) Division 3 of the Business and P%fessions Code, and my license is iin,Vfull force and
effec .0 t 1/4 9 4%r r7,
SIGNATURE a" L .fe ArTa b^I. ATE
hthr OWNER•BUILDERDECIARATION /I i ` Estimated Valuation $1,040.00
I hereby affirm at I am exempt from the Contractors Licenge Law. for the following
reason: (Sec. 703'l,.5,Business and Professions Code, Any city.aorr county which requires a
permit to construct; atter, Improve, demolish, or repair any struclOre, prior to its issuance also
requires the applicant !or such permit
to file a signed stateme that he is ft
r'
pursuant to PERMIT AMOUNT
I
provisions ,o! $Ae Contracror's Ucense Law, Chapter 9 (yommencing with Section 7000)0/
bivislon 3 of 'o
on and Professions Code, or Nat. �,e is exempt therefrom, and the basis plan Chk. Dep.
or
the alleged exemption. Any vlo/ation o/ Section 031.5 Dy an
applicant for a permit p
subjects thefapplicant to a civil penalty of not more than five Hundred dollars /8500).
❑ I, as owner of the property, or my employees w ffi wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not Intended 0�offered for sale. (Sec. 7044, Bulsness and Const.45.00
Pro/essions Code: The Contractor's Ucense Lawfdoes not appty to an owner of property who
builds or improves thereon and who does such work himself or through .his own employees, Mech.
provided that such improvements are not integbed or offered for sale. H, 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 6nprove for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
Strutt 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.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway, Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's CO pensatlon Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy N Company
opy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 45.00
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed H 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 any. person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: H, 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 Lin
Rear Setback from Rear Pro . ne
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback.fro / erLine
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, Side Setback from PGO erty Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. .
This is a buildin FINAL DATE IN�CTO
TR
g permit when property filled out, signed and validated, and is subject to
expiration if work the\
reunder is suspended for 160 days.
I certify that I have read this application and state that the above information is correct. Issued by: Date Pefmit�
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. Validated by:
Signature of applicant Date
Mailing Address Validation: ~ '—
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINii FEES r'
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK +�
POR. SO. FT. ®
-
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT.
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN,
SQ. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
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, 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.
SO. FT. RESID ® 1'/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
HOUSE SEWER
FINISH GRADING
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 Q
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
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESlINITIALS
GARDEN WALL FINAL