14925 (SFD)P.O. BOX 1504 NO. 14925
Address 7, 8"8 I.S. Nolan Circle ' LA QUINTA, CALIFORNIA 92253 Y
Owner A :c ciao, Construction t
BUILDING TYPE CONST':` ' OCC: GRP..
Mailing ��
Address 8-141. 1. "Kaiser Blvd.. #310 A:R. Number- 04-r243�-027 .
- - ,
City ` Zip Tel. Lt3 9.6 Traact .2326$
An, -Idle ifa#'CA .92808 .014) 202-•5800 Legal Description
Contractor • .. , S?6 k. aii&I C
Project Description
.'Same
Address Acacia r, -
City ,' . Zip
State Lic. City x
& Classif Lic. # Sq. Ft.. NoJ' ` No. Dw.
B 1.293954 -. 161
Arch., Engr.,nerSize - 159.1 stories units
.: :..
'Desi '•'
g - � .. New O • Add O " ' ' T Alter O Repair ❑ ' ' DemollUon (D
q �s • a
di 3A. 1tv�.rfb: Aire.�T.... l 14) 64.3'��.SQS
Santa-
-Santa-An 4toig' ids r CA ' 927 (�'I��at# _ .... k
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000)of Dwision'3 o the Business and Professions Code, and my lice is in full force and
effect 3AAn >... /Z�'Q^ ti✓' �' � -
$1GNATURE DATE • 1 '�
i OWNER -BUILDER DECLARATION' Estimated Valuation; 22l!��aa ,�qq ap "
I hereby affirm that I am exempt from 'the Contractor's License Law 'for the follow
reason:
�'t��+ V�
reason:. (Sec.. 7031.5, Business and Professions . Code: Any city or county which requires a "
permit to construct. atter,-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 - -
DivWon 3 of the Business and'Pnifessions'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 perinit Plan Chk. Dep.
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 . Plan Chk. Bal. " L • X36.78
do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and COf1St.
��+''«
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.A0
provided that such Improvements are not Intended or offered -for sale. It. however, the building -
or improvement is sold within one year of. completion, •,the 'owner -builder.• will have the burden. Electrical-'� �'•.'
of proving that he diol not build or lrnprove.lor.the purpose of sale.) '
O'1; as owner of the property; am exclusively contracting with licensed contractors to con- Plumbing 144-. 00*1-
struct the project- (Sec. 7044, Business -and .ProfessionsCode: 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: a �A
such projects with a contractor(s)-Licensed pursuant to the Contractor's License Law:): . • -
Grading - ��$.� . .
❑ I am exempt under Sec' B. & P:C. for this reason -
Driveway Enc.: 0.0,
Date owner Infrastructure 2,75.02
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
(Copy Is filed with the city, ', ❑ Certified' copy. is hereby furnished
TOTAL 3,747.63
CERTIFICATE OF EXEMPTION FROM.. REMARKS ,
WORKERS'COMPENSATIONINSURANCE ;
(This section need Trot be completed if 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 riot rz
employ any person in any manner so as to become subject to the Workers' Compensation' -
Laws of California ;
Date Owner
NOTICE' TO APPLICANT:.N, after making this Certificate of Exemption you; should become.... ZONE: BY: '
subject to the Workers' Compensation provisions of the Labor Code, - you. must forthwith -
comptywNnsuch provisions orthis permnsnaneedeemed revoked: _ Minimum Setback Distances:
Front Setback from Cenfer Line
Rear Setback from Rear Prop.;Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE•IS UNLAWFUL-, AND Side Street Setback from Center Line
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, Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF. THE LABOR CODE, INTEREST, 'AND
ATTORNEY'S FEES. //Ai /
This is a"building permit when properly filled aut,•sigried,and validated, and is subject to, ' FINAL•DATE' IN
ECT�O
expiration it work I ereunder is suspended for -190 days.
I certify that 1 have -read this application and state that -the above information is correct. Issued by Date Permit
t'agree tacompIN
wth all city and county ordinances„and.state laws relating to building
constructlon, and hereby authorize representatives' -of -this city to enter . the , above Vfl_ Ildated by: _
mentioned property for Inspection purposes.
Signature of applicant
Dates �' wr1 •� Q
9.. �'✓ �/ r
Mailing Address Validation: \
City, State, ZiP 1 / i
CONSTRUCTION ESTIMATE
NO. •ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. 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 pnperty tax valuation
_
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
y�
1
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.0
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
BOND BEAM
SQ.FT.GAR Q 3/4c
HOUSE SEWER
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 f/dy ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE U
_
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
y�
1
GAS (ROUGH)
' ETER LOOP
`
HEATING (FINAL)
OTHER APP.IEOUIP.
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. r
FRAMING 7-2
FINAL INSP.
ROOFING
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REMARKS:
IF r
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL j
LATHING 1
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL