15717 (BLCK)Buildin 3
s 57- 235 -4ve Juni r z
Address
Owner -
Esequi,el +CAronel
Mailing
Address 1>•+4. Box 12is
Q, 4inta
vvnuai.rvi s-•
.ctJY'Ca3ie CGlnetruc
Address
5alue as above
City : Zip —
State Lic. 6391
& ;Classif:: .
Arch.; Engr.;
Designer-
• s
y/
P.O. BCx 1504 N O . 15 [ 1 � -.
78-495 CALLS TAMPICO -
LA QUINTA, CALIFORNIA 92253
BJILDING: TYPE CONST. OCC: GRP.
A.R. Number, 774032-018
Tel. .564-4604 t 1d 1. :..Slock 179
Legal Description
P'.=oject Description 2 Retaining Wall 100 s
Tel.. f
w
Lic.' # 2261.
` Sq. Ft. No:
Size Stories
New ❑ Add: ; Alter ❑
Address ;` Tel.
City ", `Y - 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
I hereby affirm that I am exempt from the Contractor's License Law for the following
.. reason: (Sec. 7031.5,Susiness and. Professions Code:, Any city or -county whichrequires a
Permit . to construct alter, improve, demolish, or repair any. structure, prior to its issuance.also
requires the applicant for such permit to Ole a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing -with Section•7000) of
D'
r
wfslon 3 0l the Bus/ness 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'.
subjebts'fhe applicant to a civil 'penalty of not more than five hundred dollars ,(S500). -
O J, as owner of the property, of 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 or 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 Inprove for the purpose of sale.)
Plan-Chk. Dep.
-
'
Plan Chk. Bal.
Const.
Mech..
- - -
Electrical.
'
Plumbing- .
O'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
S.M.I. -
-
does not apply to, an owner of property who builds or improves thereon, and who contracts for
such, projects•with'a contractors) pcensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATIOWDECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workerts Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.) .
'
Policy No. Company `
O Copy is filed with the city, ❑ Certified copy is hereby furnished.
TOTAL
e .
.. CERTIFICATE OF EXEMPTION FROM
- WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need, not be, completed if the.- permit is for one hundred dollars (S 100) . valuation
.or less.) -
- I certify that in the performance of the work for which this•permit is issued, I'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. O;' after making this Certificate o/ Exemption' you-. should become ...�
subject to the Workers' Compensation provisions 'of the Labor Code, 'you must "''
comply. with such Provisions of this permit shall be deemed revoked. -
,ZONE: ' • BY: ' .,
Minimum Setback Distances: - .
Front Setback from Center Line
Rear Setback from Rear Prop. Line
-WARNING: FAILURE TO SECURE WORKERS'. COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL. FINES UP TO ONE
Side Street Setback from Center Line
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION.T.O THE -COST OF COMPENSATION; ..
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE; INTEREST;:AND
Side,Setback from Property Line
ATTORNEY'S FEES.
This ` A building permit when properly filled out, signed.and validated, and is:subject to
expiration it work thereunder is suspended for 180 days. • ..
FINAL DATE
INSPECTOR
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: . • • . .
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Malling,Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEE`
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
2ND FL. SO. FT. @
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SD. FT. @
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. @
OTHER APP.IEOUIP.
DRINKING FOUNTAIN'.
SO. FT. @
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR GRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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, TEM/PERM.
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 @ 1+/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR @ 3/ic
HOUSE SEWER
'
GAS PIPING
PERMIT FEE
MESH
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 g
O
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
�1
LUMBER GR. "
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
•
VENTILATION
FIRE ZONE ROOFING
�N
1r'
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL