003355 (BLCK)Building .
Address 77-920 HOGS
Owner
MIGU L S. XMe,.,U3.A
Mailing
Address 77-920 NOS$
City Zip.
L4 QUM-A
Contractor
OWHBUI Desai ...
Address.
SAM
P.O. BOX 1504 N Q. U U 154 0 D
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
c
BUILDING: TYPE CONST.' -OCC: GRP.
A.P. Number 773-304-012.
Tel.
564-4614... Legal Description
Project Description 6. X-60 V= MCE.
City.
Zip _
Tel.'
State Lic.
& Classif.
City
Lic. #
Arch., Engr., _.. .
Designer
Address
Tel.
Sq. Ft',. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑
Demolition ❑
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
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
EStlmated Valuation
510 �i/0.J
W .
..
PERMIT - - - -AMOUNT
- - '
to construct,'. alter, improve, demolish, or repair any-structure,•prior to its issuance also
requires the applicant permit for such peit 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 o the Business and Professions Code, or that.he'is ekempt'therefrom, and the basis. ._
for the :alleged exemption. Any violation of Section 7031.5 by 'any applicant for a 'permit
--subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
_ ❑ 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. (Secu7044,'Buisness and.
• Professions Code: The Contractor's License Law does not apply, to an owner of property who
,I+
Plan Chk. Dep. '
Plan Chk. Bal.
COf1St. �� (}[j
w
'Meeh.
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 improve for the purpose of sale.)
'Electrical '
_
'Plumbing
❑ I, 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
S.M.I. -
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under.Sec.. B. & P.C. for this reason
,f
Grading
Driveway Enc.
Date c i A" 4 7 owner>` "f �-� -' � `".. �»
7 =�
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, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. ' ' ' . Company'
O Copy is filed with the city... O Certified copy is hereby furnished.--,
TOTAL 2nAn
REMARKS
• CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
-
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
-.rless.). .-_.
- I certify that in the performance of the work for which this permit is issued, I shall not
—employ any person in any manner sous to become subject to the Workers' Compensation
Laws of California.
4
•`..a 1.'{ 200
(e•" tt�.aN�'L:1L. ,C. �' �r
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption 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: -
ZONE:, BY:
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. 3097, Civil Code.)
- —Side Setback from Property Line
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 Iaws'relalirig to building
construction, and hereby authorize representatives *.of this city to enter the above-.
mentioned property for inspection purposes.
FINAL DATE INSPECTOR
.
'Issued by:.Date 14/87 Permit .
.
'
Validated by:
Signature of applicant —Date—
Mailing Address '
Validation:
T
,Mailing
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES`
1ST FL. SO. FT. @ $
2ND FL. SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
/
SQ.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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
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.IEQUIP.
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
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I145FLU I VM'S 51UNA 1 UKLUIN11IALb.
GARDEN WALL FINAL