003370 (MISC)Building VCG=S
Address 77-920
Owner
MIGUEi A XMG01A
Mailing
Address S•
City
L& q=u
Contractor
Address
Zip Te
92253
.,,
4
P.O. BOX 1504 No. 003370
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
- BUILDING: TYPE CONST-. OCC: GRP.;
A.P. Number 773-304-012.-
564—"14
73--304— i$2•564— 14 Legal. Description
Project Description DISH
City" _
Zip
Tela
State Lic.
City
& Classif:.
Lic. #
Sq. Ft.
No. No. Dw.
-
Size
Stories - Units
Arch.; Engr., -.. ... .. _ . _
' Designer
New .0 Add ❑
Alter ❑. Repair ❑ Demolition ❑
Address
Tel.
City
State
..
JZip
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 1 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,, 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'of the Business and Professions Code, or'that.he is exempt therefrom; and the basis .
for theAny Section 7031.5 -any for
Dep:
-
•'
alleged exemption. violation of .by applicant a permit.
' subjects the applicant to a'civil penalty of not more than five hundred dollars ($500).
.Plan-Chk.
-
Plan Chk. Bal.
. ❑.l, 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
Const.'
't(?�}
-Professions Code: The Contractor's License Law does not apply to•an owner of property who
-such
'
- builds or improves thereon: and who does 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. (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.
such projects with a contractors) licensed pursuant to the Contractor's License Law.).
.. ..
Grading
. 11I am exempt under Sec.. B. 8 P.C. for this reason '
Driveway Enc.
Date ' Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I'hereby affirm that I have a certificate of consent'to self -insure; or'a certificate o6 '
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. . 0 Certified copy is hereby furnished..
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
- . 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 tho 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: If, 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 SetbackDistances: -
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
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and.is subject to
expiration it work thereunder is suspended for 180 days. _
I certify I have read this
. .
9115187, Permit
.that application and state'that.the above information is correct.
' I
Issued by:
Date
agree to comply with'allcity 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
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SQ. FT. p
POR. SO. 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
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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U..
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR @ 3/ac
HOUSE SEWER
FRAMING
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
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
DEC 17
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL