10564 (PAT)Building
Address 76--945 Ave, Fernando
Jack Harrison
Mailing
Address same
City Zip Tel.
La guinta 92253
Contractor
K.T. Construction
Address.
Bowden Lane
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City
Zip
Tel.:
Bermuda Runes
92201
345-8042
State Lic.
& Classif. B421915
City
Lic. # 1484
Arch., Engr.,
Designer
Address
Tel.
City
Zip
State
Issued by:
Date _ Permit
Lic. #
! LICENSED CONTRACTOR'S'DECLARATION
I hereby affirm.that I am licensed under provisions of Chapter 9 (commencing with Section
,70go of Division 3 of'the Business and Professions Code, and my Imcense'is in full force and
05IGNATURE UAIE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Businass 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
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
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.)
❑ 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
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 '
❑.Copy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE -
his section need not be completed if the
R p permit is for one hundred dollars �100J valuation
or less.) f ,.+``
I certify that in the performance o ftho work for which this permit is issued, I shall not
=any person in any manner so',as to become subject to the Workers' Compensaflo
Laws of California.
Date -Own
NOTICE TO APPLICANT.` � after making this Certificate of Exemption you should become
subject to the Workers' Compehsation provisions of 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 slate 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 sof this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 10564
BUILDING: TYPE CONST. OCC: GRP..
A.P. Number
Legal Description
Project Description
PATIO COVER
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Sq. Ft.
Size 324
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
FINAL DATE
INSPECTOR
Issued by:
Date _ Permit
Validated by:
Validation:
Estimated Valuation
4,244.40
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
46.80
Const.
72.00
Mech.
Electrical
- '•
r
Plumbing
S.M.I.
.50
Grading
Driveway Enc.
Infrastructure
.
e• e5 i'tfln < fL •7h',•r 1'i'?._(j;h�4l rj � �
TAS H '! 13 f AL
Y
TOTAL
119.33
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 _ Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. 50. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. 50. FT.
HEATING (ROUGH)
STORAGE TANK
POR. 50. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE PIPING
CAR P. 50. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
WALL 50. FT.
DRINKING FOUNTAIN.
S0 FT ®
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
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
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.
SO. FT. ® c
BATH TUB
FIREPLACE
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V/ac
HOUSE SEWER
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
i
SETBACK
ROUND 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 L
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
I
wagFINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
February 1, 1992
On this date, I have reviewed the plans for a Patio
Cover for the home of Jack Blum atm 945 Avenida Fernando9,�
in the Los Estados Development of the City of_La Quinta.
I find the subject plans meet or exceed all require-
ments of the Los Estados Architectual Rules and Regulations.
Y