001733 (AR)Building
Address 48,--7
Owner
mailing
Address
Ramp
City Zip
TA Cain z
Contractor
T a W�t 4 4Q�rw
Tel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Aaaress I
53-W f
City lZip Tel."
State Lic. I City
& Classif. 4Lic. #
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Arch., Engr., '
Designer am
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARASION
I hereby affirm that I am lice"nsed under provisions of Chapter 9 (commencing with Section
at7000) of` Division ,of the Business and Professions Code, and my license is in full force and
fec
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 issuanceralso•.
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, Chapter9 (commencing with Section 7000) of
Division 3 or 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
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 or property who builds or improves" thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
i WORKERS' COMPENSATION DECLARATION
Ihereby 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.)
i Policy No. Company
❑ Copy. is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
I (This section need not be completed if the permit is for one hundred dollars ($100) valuation
I or less.)
I certify that in the performance of 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 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
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 sof this city to enter the above-
mentioned property for ins,pec_lion purposes.'
Signature of applicant -4-
—Date _r('f f rti�
Mailing Address
City, State, Zip f
No. 001733
BUILDING: TYPE CONST. 41 OCC: GRP. Ts <
A.P. Number 4141-211-0112
Legal Description T RAE
Project Description
'Prem a&-UtAm PA)d Gazebo
Sq. Ft. No. No. Dw.
Size 40. Stories - 1 Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
HARD COPY
- T
§timated Valuation S y
876.00
BY:
PERMIT -..
AMOUNT
Plan. Chk. Dep.
Plan Chk. Bal.
44.5
Const.
fx.5i
Mech.
Electrical
INSPECTOR
Plumbing
Date �`�•"�� Permit
S.M.I.
Grading
Validation:
Driveway Enc.
Infrastructure
1U 1 25,55 Ck
TOTAL
129 _ 5115
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:
A2I"38
1U 1 25,55 Ck
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST 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. SQ. FT. ®
FOUND. REINF.
GAS (ROUGH)
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CARP. Q. FT.
GROUT
WALL SQ. FT.
'
DRINKING FOUNTAIN
SO. FT. ®
BOND BEAM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as properly tax valuation
FLOOR DRAIN
MECHANICAL FEES
ElfFINAL INSP. a
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
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, TEMIPERM
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
SQ.FT.GAR ® 3/4c
HOUSE SEWER
INSULATION/SOUND
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
a
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
ElfFINAL INSP. a
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL