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151955 (SFD)' DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE COUNTY OF RIVERSIDE AMIL CONSTRUCTION ESTIMATE ELECTRICAL FEES PLUMBING FEES '1st FI. Sq. Ft. p 0 NO. NO. 2nd FI. S , Ft. R rt Por. 4 Sq. Ft. @ Z G 1. i, Gar. V r Sq] Ft. @ 12 POLES S 'T Car P. .SQ. Ft. SIGNS DRAINAGE PIPING Pr Wall Sq. Ft. TRANS. AND/ OR T. cLK. DRINKING FOUNTAIN l SQ. Ft. MOTOR H.P. URINAL MOTOR H.P. WATER PIPING ESTIMATED VALUATION $ MOTOR H.P. FLOOR DRAIN ,NO. MECHANICAL FEES MOTOR H.P. WATER SOFTENER HEAT APPLIANCE MOTOR H.P. WASHER (AUTO) ISH) I INLETS - OUTLETS FIXTURES GARBAGE DISPOSAL / t M. SQ. FT. - UNIT HEATER OUTLETS LAUNDRY TRAY IL M. SQ. FT. - PERF. CEILING MAT. SUB -PANEL / KITCHEN SINK APPLIANCE VENT WATER CLOSET 1, O C` GAS PIPE RANGE AND/OR OVEN y LAVATORY REPAIR OR ALTER WATER HEATER SHOWER `p VENT SYSTEM ❑ HOOD ❑ EVAP. COOL ❑ SPACE HEATER BATH TUB ,SD ,i COMPRESSOR CONSTRUCTION POLE WATER HEATER i COMPRESSOR SERVICE ENTRANCE oo SEWAGE DISPOSAL Mr, COMPRESSOR ESID. 11 SQ. FT. HOUSE SEWER GARAGE fC SQ. FT. 2.V {� GAS PIPING IJV II, PERMIT FEE PERMIT FEE CalPERMIT FEE E M N11M E REN DBL J PLN CHK FEE CONSjEE EAT & VENT ELECT. FEE PLUMB. FEE TO AL FEES ,PLEA N�C�H 6�C KER J F M A M J J A S O N D J F M A M J J A S 0 N D BUILDING INFORMATION JOB ADDRESSow ERWOOD CONCRETE FIREPLACE CONCRETE PIERS MEMBRANE USE -QF BUILDI G DATLOCK [ON FRAME STUCCO BRICK CONC. METAL OTHER 09 Co NIT _, DISTRICT F.C. UNITS VA ATION OFFICE LASTER DRY WALLROOF C,QV RINGBD. RMS. LEGAL DESC IPTION�. PE I N M R ZO ING CHECKED BY PERMIT USE NO. �I/�.. `� `y 40 fVr /' SUPPLEMENT TO PERMIT SET FRONT SIDF REAR LOT SIZE BACK D FINALED DATE INSPECTOR GROUP TYPE BOND BOND CASH + $llf 1$ PLAN CHECK FEE CONTRACTOR Ut L) 4 ' _ _Di� 1 {j • RELEASE BOND $ LICENSE -TYPE D "1 DATE MECHANICAL FEE In accordance with Sec. 302-D of the Uniform Building Code, this permit shall $ expire if work is not commenced within 60 days, If work is suspended or oban- 00 Boned for a period of 120 days, this permit shall automatically become null - CONSTRUCTION FEE and void. $C This permit is issued, and shall continue in effect, pursuant to the terms and 'onditions of Sec. 3800 of the Business and Professions Code and as a condi- ELECTRICAL FEE J -tion of the issuance hereof the following certificate is executed. $ OWNER -BUILDER CONTRACTOR PLUMBING FEEL hereby certify that in performance I hereby certify that in performance TOTAL FEE $ b of the work for which this permit is sued I shall not employ any person of the work for which this permit is issued I have complied with Title 8, n any manner whatsoever as to be- Article 3, Sec. 3800 of the Laoor CASH CHECK M. 0. N. Come subject to the Workmen's Com- Code, and a certificate or certified C. pensation Laws of the State of copy is on file with the Riverside tRECEIV D Y PLAN FILE California. County ui ding Department. R. # /'� I V V `'� j.WAT V LU E S TIC TANK LEACH LINE SEEPAGE PIT Owner Address Contras or 4 / O.. Address �C ©� � GAL. so. FT. � Tel . Telephone .5'-q6�C'l�Lic.a „LETTER F_� FILE' 4 P.O. BOX 1504 APPLICATION ONLY Building �� ! __ 7&105 CALLS CALIFORNIAESTAD9 Address fvj' ��j, LA QUINTA, ORNIA 92253 Owner _ E� A%+ BUILDING: TYPE CONST. OCC. GRP. Mailing V Address A.P. Number CityZip Tel. t ' C�-� <=,�„�L �� �� Legal Description Contractof Project Description Address ' Cityt_l/t. llt lzipl_�1_771��_ Tel J6��� ' State Lic. City /� & Classif. �� Lic. # Sq. Ft. T No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State _ Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that am licensed under¢provisions of Chapter 9 (commencing with Section 7000) of D.i Tm, thn 3 Ot I a Business and`Professions Code, a �niy license is'n full force and effect. 7'` f��sl. SIGNATURE �' .n` A{ DATE OWNER -BUILDER DECLARATION Estimated Valuation `' I hereby affirm that I am exempt from the Contractor's License Law for the following VtJ OOO �/ reason: (Sec. 7031. S, 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 rile 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 the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than live hundred dollars ($560.,). l7 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. FO, do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. r /%D 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, Mech. 28 VD that such improvements are not intended or offered for sale. If, however, the building 1 or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 31, 7o of proving that he did not build or improve for the purpose of sale.) e�-� I 1 I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 63 r4T/ 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.I. / /0'/0 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading tl I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION IlkJ 1 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 C7 Copy is filed with the city. ❑ 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 the 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 ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. 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 that I have read this application and state that the above information is correct. Issued by: Date Permit Iagree to comply with all 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 Validation: City, State, Zip BUILDING DIVISION CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES COLL, AREA 1ST FL. SO. FT. @ $ ROUGH PLUMB. UNITS i STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. YARD SPKLR SYSTEM METER LOOP HEATING (FINAL) 2ND FL. SO. FT, p REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE MOBILEHOME SVC. BAR SINK WATER SYSTEM POR. SO. FT. @ =$ LUMBER GR. FINAL INSP, FRAMING FINAL INSP. GAR. SO. FT. @ ROOFING POWER OUTLET ROOF DRAINS REMARKS: VENTILATION ------------ DRAINAGE PIPING FIRE ZONE ROOFING CAR P. SO. FT. 0 FIREPLACE SPARK ARRESTOR WALL SO. FT. p GAR. FIREWALL DRINKING FOUNTAIN LATHING SO. FT. @ MESH URINAL INSULATION/SOUND ESTIMATED CONSTRUCTION VALUATION $ FINISH GRADING WATER PIPING NOTE: Not to be used as property tax valuation CERT. OCC. FLOOR DRAIN FENCE FINAL MECHANICAL FEES INSPECTOR'S SIGNATURES/INITIALS WATER SOFTENER GARDEN WALL FINAL 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. @ c BATH TUB SO. FT. r@ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID p 11A c to SEWAGE DISPOSAL SO.FT.GAR V c ro HOUSE SEWER GAS PIPING PERMIT FEE / PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.0 E CONST. FEE ELEC . FEE SMI FEE PLUMB. FEE 2e- �``jg3 6Y3 r0 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. $ plus xb =$ LUMBER GR. FINAL INSP, FRAMING FINAL INSP. ROOFING 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