15215 (RPL)�! P.O. BOX 1504
Bullring 52-315 Ave. Juarez LA O8-495 CALLE Address U NTA, CALIFORNIACAL F 9
ORN 253
Owner , �``asequiea. Coronel
Mailing
Address P.0. .Box.
City
La Quintal, CA ziP92253
Contractor'
C bronea Construction
Address
Same
Zip
State Lic.
& Classif.. t 634981
" Arch.; Engr.,
Designer ,
Address
No. 15215
BUILDING: TYPE CONST. - OCC: GRP.
A.P. Number
Tel.
564-•4604 Legal Description
Project Description Pool
clay
Lic. # 2251 Sq. Ft. .No. No. Dw.
Size Stories- Units -
Tel.
City Zip State
Lic. #-
LICENSED CONTRACTOR'S DECLARATION
zl herebyy aff"iim�.that I am.licensed under Provisions of Chapter 9 (commencing with Section,'
X000) of DivisioV3 92the Business and Professions Code, and my licenselivin'full force and
>r y OWNER -BUILDER DECLARATION
I hereby affirmethat I am exempt from the Contractors 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 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 rive hundred dollars (8500). '
❑ 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, Bulsness 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.)
❑ 1, 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 contractors) 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 he eii�firm that I have a certificate of consent to self -insure, or. a certificate of
Worker0ompensation Insurance, or a certified copy thereof. (Sec..3800, Labor Code.)
Policy. c• .Company
Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
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 parson in any manner so as to become subject to the Workers'' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ti, after making this Certificate of 'Exemption you should become •.
subject fo the Workers' Compensation provisions • of the Labor Code, you must' forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
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,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled'out, signed and validated, and is subject to
expiration it 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 .,of this city to enter the above-.;
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
New ❑ Add ❑ Alter ❑ Repair 0,
-Demolition ❑
REMARKS
ZONE: BY:
Minimum Setback Distances: ` r -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback f C Center Line
Side Setback from f erty e
FINAL DATE / SPE.rfTr)R
Issued by: D i65� ��< ermit
Validated by:. �Yw 4//.
Estimated Valuation 481000.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
1 64.38
Const.
99.00
Mech. '.
24.00
Electrical
45.00
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
259.35
REMARKS
ZONE: BY:
Minimum Setback Distances: ` r -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback f C Center Line
Side Setback from f erty e
FINAL DATE / SPE.rfTr)R
Issued by: D i65� ��< ermit
Validated by:. �Yw 4//.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
r
1ST FL. SQ. FT. ® $
UNITS
A.C. UNIT
2ND FL. SQ. FT.
SLAB GRADE
YARD SPKLR SYSTEM
POR. SO. FT_ ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
SEWER OR SEPTIC TANK •
DRAINAGE PIPING
WALL SQ. FT.
DUCT WORK
DRINKING FOUNTAIN.
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
REINF. STEEL
FLOOR DRAIN
MECHANICAL FEES
TEMP. POLE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER HEATER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRYTRAY
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.
SO. FT. ® c
BATH TUB
1A9-6ar111-xVENTILATION
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FIRE ZONE ROOFING
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 PLUMBII!
UNDERGROUND
�/i
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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
S
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP..
FRAMING
FINAL INSP.
ROOFING
1A9-6ar111-xVENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
.'�
I -s-
'AELF ctas-,,��G k
CATCN,NG GATE.
Jp00L -11"Y-72-'. 3 -7t -cep
7
DECK -3'85�, rr
/ N. F. ?v/f" F-11--rez
12.1
oe LL
),l 1,1614T -f PbbL,&WjTr_Ma\A/
POOL AREA TO BE ENCLOSED BY
rMl N I NA U M 5 FT. HIGH, G H, C E,
8E. - q�
T7
4,L, S T.0
-CLOSING
ALIL GATES T'O BESEL�
AND SELF -LATCHING.
CITY 0 F LA Q U It N
BUILDING & SAFETY DEPI'l
CONDITIONALLY
ACCEPTED FOR
SUBJECT TO INSTALLATONI:45,, 'PER
AND ALL APPLICABLE GOD
DATE
po
'AELF ctas-,,��G k
CATCN,NG GATE.
Jp00L -11"Y-72-'. 3 -7t -cep
7
DECK -3'85�, rr
/ N. F. ?v/f" F-11--rez
12.1
oe LL
),l 1,1614T -f PbbL,&WjTr_Ma\A/
POOL AREA TO BE ENCLOSED BY
rMl N I NA U M 5 FT. HIGH, G H, C E,
8E. - q�
T7
4,L, S T.0
-CLOSING
ALIL GATES T'O BESEL�
AND SELF -LATCHING.
CITY 0 F LA Q U It N
BUILDING & SAFETY DEPI'l
CONDITIONALLY
ACCEPTED FOR
SUBJECT TO INSTALLATONI:45,, 'PER
AND ALL APPLICABLE GOD
DATE