14871 (RR)P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 54-200 Ave. Cortez LA OUINTA, CALIFORNIA 92253
Owner David tiCalsi
Mailing
Address Same
City
La 'Quanta,_ CA
92253
Oakwood -Construction
66k '126 ..
kat» springs, 1'
State Lic.
& Classif.. ' g 528864
Arch., Engr,;
Designer
Address
No. 14871
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number.
Tel.
Legal Description
Project_ Description Reroof
Tel.:
92263 325-5270
City
Lic. #
Tel.
CityZip I
State
Lic. #
LICENSED CONTRACTOWs DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) of 9M on 3 of the Business and Professions Code, and my license is in full force and
}fact. {,
DATE
iz OWNER -BUILDER DECLARATION
I hereby affirm that l am exempt from the Contractor$ License Law for the following
reason: (Sec. 7031.5,&a*wss.and Professions L1ode:.Ary city or county. which. requires a
permit to construct, after, ,bnprove, dernoUeh, or repeY any abuclrne, prior to Its issuance also
requires rhe epparant for such permit to Me -a so. statement that he Is-IRansed;pursuant to
the provisions o/ Me Contractors Licenselaw, Chapter 9 (coeseencbmy with Section 7000) of
Division 3 of the Business and Profession Coda, or that. he /s exempt therefrom, and the, bash;
for the allayed exanglllon. Any viafation of Section 7031.5 by Any applicant for's permit
subjects the applicant -to a civil penally of not more than rite hundred dollars (6500).
❑ 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, Bulginess and
Professions Code: The Comedtors License Law does not apply to an owner of property who
bulkls or Improves thereon and who does such -work himselfor through his own employees,.
provided that such brprovmnents are not Intendedor offered for safe. N, however, the building
or_Improvement is sold wiMbt one year of completion, the owner-buoder wQl have the burden
of pmving that he.dld not build or Improve for rhe purpose of sale.)
❑ 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
doesnot apply to an, ownerof'property who builds or Improves thereon, and who contracts for
such projects with a. contracta(s) pcensed pursuant to the Contractor's License Law.) -
❑ 1 am exempt under Sec. w, g P.C. for this reason
Date owner
WORKERS COMPENSATION DECLARATION
I hereby firm tiwt'1 have a certificate. of consent to self -Insure,. or a certificate of
Workers CO ensatlon Insurance, or a certified copy thereof. (Sec. 3900, tabor Code.)
Policy N Company
py Is filed wlth the city. ❑ Certified copy Is hereby fumished..
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need 'not be computed N 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, l shall not
employ any'ppeersoa in any manner so as to become subject to the Workers' Compensation
Laws of California
Dates .Owner
NOTICETO APPLICANT: It, after maktrp this Certificate of. Exemption you should become
subject to the Workers' Compensation provlslons of the Labor Code, you must forthwith
comply with such provisions or tics Permit shall be deemed revoked. -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
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,.
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES.
This Is a bu0ding permit when properly tilled out, signed and validated, and is subjectto
expiration It 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 represenwhr s of this city to enter the above..
mentioned' property for inspection purposes.
Signature of applicant Date
Meiling. Address
City, State, Zip
Sq. Ft. No.
Size Stories -
New ❑ Add. ❑ .` Alter ❑
stimated Valuatiom. $1,-500:00
No. Dw.
Units
Repair ❑ Demolition ❑ .
PERMIT
AMOUNT
Plan Chk. Dep.
Minimum.Setback Distances:
Plan Ch_ k. Bal.
Const.
30-00
Mech.
Line
Electrical
Side Street'Setback from
Plumbing
S.M.L
ine .
Grading
Driveway Enc.
Infrastructure
INS
Issued. by
-. - F.,' r• - -:
Date s >
,per,, .
mit
1
Validated by:
TOTAL
30.00
REMARKS
ZONE:
BY:
Minimum.Setback Distances:
Front Setback from Center Line
Rear Setback from. Rear Pro
Line
Side Street'Setback from
a ine
Side Setback from Prop
ine .
Q
FINAL DATE
INS
Issued. by
-. - F.,' r• - -:
Date s >
,per,, .
mit
1
Validated by:
S.
Validation•
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. Sp. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. gp, FT. ®
DUCTWORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER,APPJEOUIP.
DRAINAGE PIPING
CAR P. SO. FT.
TEMP. POLE
WALL SO. FT.
GROUT
DRINKING FOUNTAIN
SO FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION i
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
=S
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SO. FT. ® c
BATH, TUB
GAR. FIREWALL
SO. FT..@ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1t4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 34c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST..F.EE 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
DUCTWORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER,APPJEOUIP.
REIN F. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
S plus xS
=S
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"
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL 71