The URL can be used to link to this page

11462 (RER)TA• �� 4 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 5321.5 Avenida Navarro LA QUINTA, CALIFORNIA 92253 - Charles Thatcher Mailing Sq. Ft. Size No. No. Dw. Stories Units Address 16611 Ave.nicia De Laren.a City Zip Tel. La Jolla 992037 Contractor Estimated Valuation Z.A. Henry, Co. PERMIT Address Plan Chk. Dep. Plan Chk. Bal. PeO. Box 835 Const. City Glendora /.!)^ • `U zip 91740 . Tel' 714-599-8425 State Lic. 0 . _U0 Plumbing City & Classif. 3.46667 B-1 • Ju Lic. # Arch., Engr., Driveway Enc. Designer Infrastructure Address Tel. CityI Zip I State Lic. # LICENSED CONTRXCTOR'S DECLARATION I hereby affirm.that:l amdicensed under provisions:of:Chapter 9 (commencing with Section 7000) of Division 3 of the_Buusiness'and�Professioris Code, and my license is in full force and effect.,,,, Ye=s f./� i r - 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, after, 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 apprxmnt for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ 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 Ucense.[aw does not appy 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. lf, however, the building orimprovement 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 hereby 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.) Policy No. Company ( O,Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation , or less.) I certify that in the performance of thg work for which this permit is issued, I shallinot 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 Firemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 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.) 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 -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 31462 11LDING: TYPE CONST. OCC: GRP. 14 P. Numbers'r3.til'm;.!ttai?n Description_ t Description Fire RestoratlLon Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation ;25..000.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. - �• tYU Const. /.!)^ • `U Mech. . s . Eat! Electrical 0 . _U0 Plumbing i!) . 50 S.M.I. • Ju Grading Driveway Enc. Infrastructure TOTAL 4' %V.3. .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: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. ® POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. ® WALL SQ. FT. ® SQ. 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 COLL. AREA FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FORMS GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SEWER OR SEPTIC TANK LAUNDRYTRAY AIR HANDLING UNIT CFM ROCK STORAGE 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. SQ. FT. ® c BATH TUB TEMP. POLE SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 Vic SEWAGE DISPOSAL WATER HEATER SQ.FT.GAR ® 3/ac 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. FEEEA SMI FEE PLUMB. FEE STRUCTURE PLIYKBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK r UND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE�L 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 GRADING cu. yd. $ pIus x$ =$ LUMBER GR. FINAL INSP. FRAMING fl/ 30 m co FINAL INSP. ROOFING 36 4 c -• d 1(13t• I f )S 4 -,oil REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL )3 Kzf LATHING !a %t! N `_' MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL iUT11:1CATION,OF .FIRE : `CI,T.Y OF LA QtSI i -ATA . DATE } TYPE OF FI RE STQ UET . TIME ti . CAUSEfLI+tiIG ry - DOLLAR DAMAGE PROPERTY. 06(� CONTENTS ICj, ooc TYPE OF OCCUPANCY �ItAe6r ll y 1/��LI✓II�G PHYSICAL DAMAGE" 1 'A- AAC� �.n.0i SAT. 4A AC- tAD2 PROPERTY OWNER , 6. Som CA • q -2b--3,C- TENANT I,�.I'D�-�C65, �ATtZ1C LI IV(D� d��'(-- LA Dol G z z BUILDING INSPECTION NEEDED LqS,A:�(? ' NOTIFICATION SENT'TO DATE TIME ...'