003757 (RPL)Buildin
Address. 78-254 Calle Norte
Owner
mailing -
Address
City - - Zip
Tel.
La- QuInta .. 92253 .
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• Contractor
.C61 iftmia Pedis ;pas
Address
67-712 Ramon Road
Ci.tY. Zip
Tel
U t city -92234 " _
32
State, Lic.
City
& Classif. b�IJ�� _..
Lic. #
Arch., Engr.,
- Designer William Ferrel l
Address
Tel.
P.O. BOX 1504 N U U 3 1to I-
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP:-
A.P. Number 769-022-030....
Legal Description
Project.Description sp,a
Sq. Ft. - No. No. Dw.
Size • - Stories .. • Units
City,�, Zip - State ':' - "
Zi _ .. Lic. # '.
LICENSED_CONTRACTOR'S DECLARATION 4
I hereby affirm'thathfam licensed under provisions of Chapter f;, (commencing with Secti
7000) of Division 3 of_the Business and Professions Code, and my license is,in,full force a
effect. . i i ,, rt .r >fx
• Add ❑,• - . Alter ❑••. . Repair ❑ Demolition ❑
t f 14i _ fl
.. SIGNATURE —. _ - �.-. - -_ •..,,,,: -'i• �ODA.TE
..
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.' OWNER -BUILDER DECLARATION
' I hereby affirm that I am.exempt from the Contractor's License law for the following
.. ..
EStlmated ValUatlOn
-
. ... .. .. ..
- ••
. reason: (Sec.., 7031.5, Business and Professions Code: Any city or county which requires a•i._I`:ii'
•
permit to construct, alter, improve, demolish,, or repair any structure, prior to its issuance also
_
requires the applicant for such permit to file signed statement that he is licensed pursuant to.-
-' PERMIT•--
- •' .; - AMOUNT ' _x
the provisions of the Contractor's License Law, Chapter 9. (commencing with Section .7000) of
C.
Division 3 of the Business and -Piofessions Code; 'or that. he 'is exempt therefrom, and the -basis
• for -the alleged exemption. Any violation.of Section 7031.5.by: 'any
-� Plan Chk: Dep.-
-
applicant •for a permit •
'subjects the applicant to a civil penalty of not more than five hundred dollars ($500). •" '• . �'-
1, m -with
Plan �Chk. Bal.
-
-
p4 59
❑ as owner of the ro ert , or employees wa es as their sole'_com compensation, will
P P Y Y9 P
do the work- and the structure is not intended or offered for sale. (Sec. 7044,' BLisness and•
Professions Code: The. Contractor's
'- Const,
","`e •
-
. 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. -
.,
-
`tet
provided lhat'such improvements are, not intended or,offered'for. sale. If, however,. the building ; _
.•(30
•• or improvement Is sold within one year of completion, the owner -builder will have the burden •.
Electrical
'• �•
MAO
of proving.. that he did not.build or improve for the purpose of sale.)
i3
' O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing�.I
El
,Strutt the projec6•(Sec. -7044, Business and Professions: Code: The Contractor's License Law -.
_
does not apply toanowner 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.)
Grading
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' A' 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
• `� , `a `�`
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 the work for which this permit is issued, I shall not
�R+1-dsJ.r L� 7b t(s +xt csi_'tsy3 Yv
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
ZONE:
BY'
subject to the Workers' Compensation provislons-of the 'Labor Code,' you must forthwith•
Minimum:Setback
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comply with such provisions or this permit shall be deemed revoked. - - - "
Distances: - - `
Front Setback from Center Line
.• ..:
Rear Setback from Rear,Prop. Line
- CONSTRUCTION LENDING AGENCY
'1
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
FINAL DATE"
INSPECTOR'
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. +
_..., .
certify that I have read this application and. state that the above information is correct.
'611
!Issued by: -
- '�--Date- Permit -
• I agree to comply with city and county ordinances and'state laws relating to building
- ...••
• - _
. - construction, and hereby authorize representatives • sof this city to -enter the 'above '
mentioned property for inspection purposes..
Validated by:
'
• Signature of applicant - Date'
Mailing Address
Val.ldation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SQ. FT.
POR. SQ. FT. @
GAR. SQ. 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 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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. @ c
BATH TUB
BOND BEAM
SQ. 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
I 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 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.
FRAMING
FINAL INSP.
ROOFING/�
n
YyJK
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
Isarr%.1 vn o aW nA 1 V nCDmm I IALa.
GARDEN WALL FINAL