10611 (BLCK)P.O. BOX 1504 No. 10611
Building 78-105 CALLE ESTADO 4 � r
Address 54-395 JUAREZ LA QUINTA, CALIFORNIA 92253 t .,�' ,
Owner
Mailing WILLIAM DAVENPORT BUILDING: TYPE CONST OCC: GRP.
Address 54-395 JUAREZ
A.P. Number
City Zip Tel.
LA QUINTA 92253 Legal Description
ContractorProject Description S.LitF4 t&I 13 I i I
OWNER I3i3I" DER 49' B 5' AND 56' X-6'
Address .
City Zip Tel.:
State Lic. City
& Classif. Lic. # Sq. Ft. 'No. No. Dw.
Arch:; Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City 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 Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License law for the following: $2.460.85
reason: (Sec. 7031.5,Business and Professions Code: 'Any city or county which requlres a
permit to construct, alter, improve, demolish, or repair any structure, prior to its Issuance also AMOUNT
requires the applicant for such 'permit 4o file a signed statement that he is 'licensed pursuant to PERMIT
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 Plan Chk. Dep. . .
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). '
as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do'the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. $ i¢ (3�
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, . . Mech.
provided that such improvements are.not intended or offered forsale.• If, however, the building
or improvement Is sold within one year of completion, the owner -builder will have'the burden Electrical '
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 Plumbing
struet the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law Q
does not apply to an owner of property who builds or Improves thereon, and who contracts for S.M.I'. - •
—••• such projects with a contractor(s) licensed pursuant to the Contractor's43cense Law.)
O 1 am exempt under Sec. B. & P. for this reason Grading
r, 1/; , 4,. / `� ` -;� / Driveway Enc.
Date Idcl °towner `� ��//tfi� r%�A Cr Infrastructure
WORKERS' COMPENSATION DECLARATION%
I hereby'affirm that I have'a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance,,ora certified copy thereof. (Sec. 3800, Labor Code.) _ -
Policy'fNb. Company
rE,XC613y. is filed with the city. ❑ Certified copy is hereby furnished.j/ TOTAL $54 • 30
CERTIFICATE OF EXEMPTION FROM'
REMARKS
WORKERS' COMPENSATION INSURANCE
_
(This section need not be completed ifotiie permit Is -for one hundred dollars ($ 100). valuation
or less.) - -
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: It, 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 from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
FINAL DATE INSPECTOR
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.
'
Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws -relating to building
r
construction, and hereby authorize representatives of this city to enter theabove-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant Dale
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SQ. Ff.
WALL SQ. Fr. ®
SQ Fr ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
I
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM 2
v�
SQ. Fr. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® Vic
HOUSE SEWER
FINAL INSP.
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
I
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSIn
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 2
v�
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
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 SIGNATURESIINITIALS
GARDEN WALL FINAL