003840 (AR)P.O. BOX 1504 No -
Building
Building 78-105 CALLE ESTADO
Address `93-155 FE�1 �0 LA QUINTA, CALIFORNIA 92253
Owner I
MR. IMM. FAUL 1"IS
Mailing
Address P.O. BOX 960
City Zip Tel.
LA QcULM 92253 564-272€3
Contractor, .
. . ' BAR CONSTRUCTION
Address .
40825 YUCQ. 10.
City - Zjp . Tela
BML40A MES 3220. 345-4048
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number ;fig 631-351"013
Legal Description LOT 146, LQ GOLF M. #1
Project Description.
ROMs ADDITION
State Lic.
& Classif.,
City
Lic. # 63
Sq. Ft.
No. No. Dw.
-irw-.,.,,1 J��lsai_ z 151.1x:
+
Size
-Stories Units
Arch., Engr.,
Designer "
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
.
Date Owner /
NOTICE TO APPLICANT. If, alter making this Certificate of Exemption you should become
City
Zip
State
., Minimum Setback Distances: -
_
Lic. # ..
Front Setback f rom.Center. Line
^
LIQENSED CONTRACTOR'S DECLARATION
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
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.. J. .
.
-
SIGNATURE DATE,
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
EStlmated �/alUatlOn
reason: (Sec. , 7031.5,Business and Professions " Code: Any, city or county which, requires a
Lender's Name
PERMIT'•
AMOUNT
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.ls 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).
O I, as owner of the property, or my employees with wages as their sole compensation, will
This is a building permit when properly filled out, signed and validated, and is subject to
Plan Chk. Dep.,
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.'
Plan Chk. Bal.
-
- 48.42
Const.
�Q
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
M2ch.
'. 10.00provided
builds or improves thereon and who does such work himself or through his own employees,
that such improvements are not intended or.offered. for sale. If, however, the building
Electrical'
18.00of
or improvement is sold within one year of completion,• the owner -builder will have the burden '
proving that he did not, build or improve for the purpose of sale.).
Plumbing-
O 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
S•M;j,.
.FSO
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
r
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
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
O Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
_ WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
rv!r�,t ta+5 ads r. -v A's AA—: 7 -Utl
or less.) _ -
I certify that in the performance of thg work for which this permit is issued, I shall not
-irw-.,.,,1 J��lsai_ z 151.1x:
+
employ any person- in any manner so as to become subject to the Workers' Compensation
Laws of California.
.
Date Owner /
NOTICE TO APPLICANT. If, alter making this Certificate of Exemption you should become
ZONE:
BY:.
'subject to the Workers' Compensation provisions of the Labor Code, you"must forthwith
comply with such provisions or this permit shall be deemed revoked.
., Minimum Setback Distances: -
Front Setback f rom.Center. Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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
Lender's 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 E+! %`RR Permit
.
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
HARD COPY
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. ®
GAS (FINAL)
WALL SO. FT. ®
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID Q 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® lAc
HOUSE SEWER
MESH
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.IEOUIP.
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
'
/
�yyy
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND S
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL