003361 (RR)Building
Address 53-576 HAVAM
Owner
RICK U-41
Mailing.
Address SAM
City Zip ITel.
LA- T 92253
Contractor
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Zip .. - Tel..
1'O 92201 345--3753:
State Lic. City
& Classif. •c.39 274921 Lic. # 12
Arch., Engr.,
Designer
Address Tel.
�0.. 00336.
BUILDING: TYPE CONST. - OCC: -GRP: -
A.P. Number 774-135444
Legal Description
Project Description re -roof
Sq. Ft. No. No. Dw.
Size Stories- Units
New Add'❑ Alter ❑ ., Repair ❑ -Demolition ❑.
City
Zip
State
Lic: #...
. LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under.provisions of Chapter 9 (commencing with Section
7000) of Division 3 of tthhe`Business and Professions Code, and my license is in full .force 'and •'
^• .
effect.
SIGNATURE DATE
OWN ER- BUILDER DECLARATION
EStlmated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the followingfc�
-city
4
• .,.reason: (Sec. 7031.5,Business and _ Professions Code:. Any 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
PERMIT - - AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with.Section 7000) of
- -
Division 3 or the Businessand_Professidns Code, or that. he: is. exempt therefrom, and the basis
for the Any Section 7031.5- by 'any for
- - -
Plan Chk. Dep.. -
.alleged exemption. violation of applicant a permit
subjects the applicant Yo a civil penalty of not more than�hve'hundred dollars ($500).
Plan Chk. Bal.
- O 1, as owner of the property, or my employees with wages as their.sole compensation,•%ill _.
do the work, and the structure is not interided or offered'for sale. (Sec:.7044, Buisness and
Const: - �ss� :fit
Professions Code: The Contractor's License Law does.not apply to an owner of property who
. 6.t AN) -
•
'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 for sale. 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 '
struct the project.- (Seca 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
S.M.I.
. such projects with a contractor(s) licensed pursuant to the Contractor's License Law:)
Grading
, ❑ .I am exempt under Sec..B. B. & P.C. for this reason .
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm"that.) 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. , .❑ Certified copy is.hereby..furnished. '
TOTAL{jf„
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE.
(This section need not be completed if the permit is for one hundred dollars ($700) valuation
-
or less.).. .. .. ,.
I certify that in the performance of thg work for which this permit is issued, I shall not
•'nR
;i.,tCa
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• youshould become
ZONE: BY: ' •r
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
hereby affirm that there is a'construction lending agency for the performance of the
work_for which this permit is issued. (Sec. 3007, Civil code.),
Side Setback fro TI Property -Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
' 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 011P#IAT Permit
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.
Validated by:
Signature of applicant Date
• Mailing Address
Validation.
City, State, Zip
�F.
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SO. FT. ®
WALL SQ. FT. ®
SO. FT. ®
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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
DEC 17
'
PERMIT FEE
PERMIT FEE
DBL
PTALFEES
MICRO FJEE
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./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
FINAL INSP.
ROOFING
c
r,
DEC 17
'
REMARKS:
VENTILATION,
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