10299 (PLBG)Tiht 4 4 Q"
Building -705 Ave. Cortez
Address
Owner
Kr. and I.1rs. Michael Bond
Mailing
Address sarie
-City Zip Tel.
La Quinta 92253
Contractor
BaookS & Associates
-_998 Avenue 52
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Coachella zip 92236 Tei.:
State Lic. City S
& Classif. 576046 Lic. #
Arch., Engr.,
Designer
Address I Tel.
City( Zip I
State
Lic. #i
LICENSED coNTRACTOR'S DECLARATION
I hereby affirm that 1 am.licensed under provisions of Chapter 9 ioommencing with Section.
7000)
of Division 3 of the B�sirhess and Code, end my license Is In full force and
�l
SIGNATURE— DATE
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractoes License Law for the following
reason: (Sec. _7031.5,13ushess and Professions Lode: Any c*y or county which regadres a
permit to construct, after, briprove, demolish. or repair any ---a. prior to Its Issuance also
requires the, appllcent for such permit to No a signed statement that he is licensed pursuant to
the provisions of rhe Contractors Lkense Law, Chapter 9 (comirnencing wIM Section 7000) of
Division 3 of the Bushass and Profession Code, or Mat. he h exempt therelmm, and the basis
for the alleged exemption. Any v A N" of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a clv9 penaltyof not more then Ove hundred dollars ($500). '
❑ 1, as owner of the property, ormy employees with wages as their sole' compensation, will
do the work and the structure is not intendedor offered for sale. (Sec. 7044, Sulaness and
Professions Code: The Contractors License Law does not apply to an owner of property who
builds or 6nproves thereon and who does such work hhmeff or through his own amployses,
provided that such AWrovements are not Intended. or offered for sale. *, however, the building
or Improvement Is Sok/ wlfhh one year of compAellba, the owner -builder will have the burden
of proving that he did not build or bnprove for;Me purpose of sab.)
O 1, 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
do" -not apply to an -owner of property -who bukb or 6nproves thereon, end who contracts for
such projects with a contractors) Licensed pureant to the Cmtractor's License Lew.)
❑ 1 am exempt. under Sec- a, g P.C. for this reason
Date Owner
WORKERS COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self-lnsure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800,. Labor -Codi.)
Policy No Company
❑ Copy Is filed with the city. ❑ Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATION INSURANCE
(This section need not be rwrnftW *the pend is for one hundred dollars ($100) valuation
or fess.)
I certify that in the performance of the work for which this permit Is Issued, I shall not
employ any ppeerson In any manner so as to become subject to the Workers' Compensation
Laws of Califomla:
Date owner
NOTICE TO APPLICANT: M, Stier rnalrtrp this CwWscdo of Exemption you should betaine
subject to the Workers' Con pensatlm provisions of the tabor Code; you must forthwrth
comply with such provklons or this perm* shall be downed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work -for which this permit is Issued. (Sec. 3097; Cha Code.)
Lender's Name
Lender's Address
This Is a building permit when property filled ou% signed and validated, and is subject to
expiration It work thereunder is suspended for 180 days.
I certify that 1 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-.
mentloned.property for Inspection purpose&
Signature of applicant Date
Malling Address
City, State, Zip
No. 10299
JILDING: TYPE CONST. OCC: GRP:;
P. Number 774-101-415
Description
Ft.
Description
Sever Hook Up
No.
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition.0
PERMIT AMOUNT
Plan Chk: Dep:
Plan Chk. Bal.
Const.
Mech.
Electrical
ee
Plumbing °
S.M.I.
Grading
Driveway Enc.
Infrastructure
ae
TOTAL °
REMARKS
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. $q. FT. ®
MOBILEHOME'SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS..(ROUGH)
DRAINAGE' PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION t
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:-
EMARKS:VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEM/PERM
LAVATORY
HEATING SYSTEM- FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 114 c
SEWAGE DISPOSAL
SO.FT.GAR ® 114c
HOUSE SEWER
MESH
GAS PIPING,
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS..(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
i plus xi
=E
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:-
EMARKS:VENTILATION
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIAL$
GARDEN WALL FINAL