14851 (CRES)P.O..BOX 1504 No. 14851
Buildng+ 78-495 CALLE TAMPICO
Addrr;ss 51-266'Calla Oba Spo LA QUINTA', CALIFORNIA 92253
Owner Kevin & Pam Moser
MailingBUILDING: TYPE CONST: OCC: GRP.
Addres Same
A.P. Number
City Zip Tel,
La guinta, CA 92253 Legal Description
Contractor ' Carport
(*mer/Builder Project Description
Address. .
City, State, Zip
City
Zip
Tel.:
State Lic.
City
& Classif.
Lic. #
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch., Engr.,
-Designer
New ❑ Add O
Alter ❑ Repair O Demolition O
Address
Tel.
City
Zip
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
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
.
'
$4,629.60
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 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
Divislori 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis
for Any Section 7031.5 'any for
Plan 'Chk. Dep.
- -
- �•
the alleged exemption: violation of by applicant a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
eI, as owner of the property, or my employees with wages as their sole compensation, will
Pld_an Chk. Bal.
_ .
LoAll
Sa
the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.i
2 00
Professions Code: The Contractor's License. Law does not appy 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 Intended or offered for sale. N, 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.)
❑ 1, 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.
.46 -
such projects with'a contractor(s) (iaensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. &- P.C. for this reason
f
Driveway Enc.
gate "n`-�t+: ' .z o Owner
Infrastructure
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
❑ Copy is filed with the city, ❑ Certified copy is hereby furnished.
TOTAL
119.26
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.)
I certify that in the performance o4 the work for which this permit is issued, 1 shall not
employ any person -in any manner so"as to become subject to the Workers' Compensation
Laws of,Calijorrjja�. �/ jr
' / . ;Oiwner o/ice PF✓ / � '
at
NOTICE TO APPLICANT: If, after making: this Certillicate of Exemption' you,: should become
ZONE:.
- -BY:
subject to the Workeis' Compensation provisions of the' Labor .Code; you must forthwith,
Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
MIr11mUm
'
Front Setback from Center Li
Rear Setback from Rear Pr i
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, -AND
Side Street Setback from r Lin
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 Pro ine
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST. AND
ATTORNEY'S FEES.
FINAL
IN ) '
This is a building permit when properly filled out, signed and validated, and is subject, to
-DATE
nECT
expiration if work thereunder is suspended for 180 days. ,cGT
I
fZerrTil
certify that 1 have read this application and state, that the above information is correct::
Issued by:
Date
I agree to comply with all city and county ordinances and state laws, relating to building
ff
construction, and hereby authorize representatives iof this city to enter the above -./9n
.
mentioned property for Inspection purposes.
Validated by:
aa77��
Signature of applicant Date
L
\,
ZZ
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. p
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT.
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SO. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING 4
I IKITCHEN 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.
SO. FT. ®c
BATH TUB
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/.c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEEMECH.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 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 4
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
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JUN -20-94 MON 1G:22 CAPRENOS
I
UNCONDITIONAL WAIVER AND RELEASE UPON
PROGRESS PAYMENT
P. 02
The undersigned has been paid and has -received a progress
payment in the sum of $ for labor, services,
equipment or material furnished to
(Your customer)
on the job of located at
(Owner)
(:ME ilesciolp—tion)
and does hereby release
pro tanto any mechanic's lien, stop notice or bond right that
the undersigned has on the above referenced job to the following
extent. This release covers a progress payment for labor,
services, equipment or materials furnished to
(Your customer)
only and does not cover any retention or items furnished after
that date.
Dated:
(Company Name)
By
(Title)
NOTICE: THIS DOCUMENT WAIVES RIGHTS.UNCONDITIONALLY AND STATES
THAT -YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS. THIS
DOCUMENT IS ENFORCEABLE AGAINST YOU IF YOU SIGN IT, EVEN IF
YOU HAVE NOT BEEN PAID. IF YOU HAVE NOT BEEN PAID, USE A
CONDITIONAL RELEASE FORM.
4411,
1_7
78-495. qA.L E TAMP16a0 LA
OU14TW"CALIFORNIA 922'5.3 (760) 77.7-7000
FAX (760) 777 i101
TDD (760) 777-1227
December 24, 001 -
Kevin &, Pam Moser
51-206 Cia Ile- "Ob-I'S'po'
-La Quinta, CA.".'91253
RIE: Carport. Permit #14851
'Dear Mr. & Mrs. Moser
The purpose of this—
;drin You4 at'your .�6ego'ri #14851, for the piqj e6t at
lletteris to,in . R
51-20OCalle Obispo, has "expired with ,j994'UBC se'ction, 106.4.' 4,.- ofurther
work'may be r -M'-' ed iiiii if ain'e`w- -'per'ni it has sbe'�
perf6i n issued
Please contact DanielT, Crawford -Jr Buildip'g,1ns;pe6t6i. 1;�,-at-,(760),:7777012 to obtain4ny
information 'you -ne.6d,'regardmg-a newpermit, afid/6''r"any re4uir4insp I ectibris. "Should you
choose not to co I niPle e the project, oj , ectwe , - would , ild' then ha e -to pursue any br all: of the. -following
Y a
actions:'
1) Abaternent.of the project through the -City ,Attorney's ,'Office .'and "C*o'de-,C6mvIiance Division.
2) Notice of n'on-c'onfbrrnmg,structur6 placed,
ppoppr6pdity profile
q,
3) Action filed with Coniia"et'o"��rS't'At'e"License Bbard.`
Optional if,Owfiei/BuiIder'.*1
fiv nce,..-Drior o rking- d to're*solve this issue,. and
Please contact us at.,your.ear'liest'c6` convenience -t o
. ' - 'have
.. ' 1 - days
4
for any questions yqti':m h
?y. ave.
Sincerely,
Mark Harold
Building & Safety Manag'er,
Daniel P. -rawfor Jr..
Building Inspect9i'll
cc: file
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