9538 (AR)TA
9538 P.O. BOX 1504 N O .
Building. 7&105 CALLE ESTADO t
Address ?S-~2010 Qr 11,-- Novi to " <. .LA QUINTA, CALIFORNIA 92253
Ed Murphv
Mailing
Address SaMe
City Zip
La .Quinta; 92253
Contracfee
A.
Address
City Izip
BUILDING: TYPE CONST. OCC: GRP..
A.P. Number
Tel.
564-3727 Legal Description
7 Addition to covered patio
l Project Description
State Lic. City
& Classif. � & _ Lic. # SFt. No.
J / Size 60Stories -
Arch., Engr.,
Designer ,Paul. .S • Anderson,- AIA New ❑ t Add ❑ Alter ❑
Address Tel. 4116, 0
53781 Ave. Herrera 564-}2688
CityZip `-.w�' State
La Quints . 92:2;3 :..• Lic. # C18,79-2
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter (commencing with Section
• i 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 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, alter, improve, demolish, or repair any structure, prior to its issuance also .
requires the applicant for such permit to,Rle'a signed statement that he Is licensed pursuant to PERMIT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
,750.00
No:,Dw.
Units
Repair Of 'Demolition ❑
AMOUNT
—vision 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 applicant -for r.a permit'
' •
.. Plan Chk. Dep..^:..
-
.
subjects the applicant to a civil penalty or not more than rive hundred dollars ($500).��
Plan Chk. Bal.
,• Z. -
❑ 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
Const.�_
'•
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,
McCh.
provided that such Improvements are not intended or offered for sale. If, however, the building
s
or Improvement Is sold within one year of completion, the owner -builder will have the burden
Electrical - -
-1-b. 0 U
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
y�-struet the project. (Sec.• 7044, Business and Professions Code: The.. Contractor's License Law
does not apply town owner of property who builds or improves thereon,'and who.contTcts for
• $. M.I',
• U
such projects with a contractor(s) licensed pursuant to the License Law.) - �-
ti
0,1 am exempt under Sec. B. & P.C. for this reason
Grading
_
Driveway Enc. -
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate (of consent to self -insure, of a certificate of
'Worker's Compensation Insurance, or a ce riled copy thereof.'(Sec. 3800 (( abor Code.)
PO Icy' o• Company r CG /"/ '1
\ Copy is, filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM R'
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 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, 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. -
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work ch 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,'end 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 f Date
Mailing Address
City, State, Zip
TOTAL 3 i% • d
REMARKS
'16:.J' ri
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:
r
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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
WATER HEATER
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
HOUSE SEWER
GRADING
cu. yd.
plus x$
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE EPLCK-FEI
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 APPJEQUIP.
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. n,Z qjA
FRAMING
l�
.0—f,$
9
ROOFING ✓ oL�L
J / C h
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION-
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES(INIMLS
GARDEN WALL FINAL