9578 (BLCK)Building 51-41,03 o I1G
Address
e
Owner
Richard Swalve
Mailing
Address
City Zip
Contractor
Richard Swalve
"c&-ty 4 4 "
P.O. BOX 1504 N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
JILDING: TYPE CONST. OCC: GRP.
P. Number
Tel.
Legal C
Project
City
Zip
Tel.:
Date Own
t
State Lic.'
City
& Classif. 35565.5
Lic. # 178.4
Arch.; Engr.,
Designer
Address
Tel: `
i
City
Zip
State
'
I hereby affirm that there is a construction lending agency for the performance of the
Lic" #
LICENSED CONTgAC�TOR'S DECLARATION
I hereby affirm hat{I' m Ilcen�ed unde Pro sions of Chapter 9 (commencing with Section
7006) of Divisi. 3 of t Busines,and'Pro,(essions COV,
a and my license is in full force and
effect. N. L.
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law, for the f • - ing
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which m a
permit to construct, alter, Improve, demolish, or•repair any structure, pdor to its ' ante
requires the applicant for such permit to file a signed statement that he is livens purrrr����ssuant
the provisions o/ the Contractor's Ucense Law, CAapter 9 (commencing with S n00) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and, t e be
/or the alleged exemption. Any violation of Section 7031.5 by 'any to e rt
subjects the applicant to a civil penalty o/ not more than rive hundred dollars p
O I, as owner of the property, or my employees with wages as th ' ole ompen will
do the work, and the structure is not intended or offered for sal Sec 044, Buisness and
Professions Code: The Contractor's License Law does not appty t o qer of property who
builds or Improves thereon and who does such work himself •or ugh w"is own p/oyees,
provided that such, improvements are not intended or offered for sal owever a building
or Improvement is sold within one year of completion, the owner- .7 h e burden
o/ proving that he did not build or improve for the purpose o/sale.
❑ 1, as owner of the property, am exclusively contracting livens ggntractors to con•
,strucl the project. (Sec. 7044, Business and Prof Cod a Can 4br'a License Law
does not apply to an owner o/ property -who build r im I es , and who contracts for
such projects with a contractor(s) licensed pursuant he Contrtor's ' se Law.)
❑ 1 am exempt under Sec. B. & . for this ason
Date Owner"
WO CO .. PENSATION DE RATION '
I hereby affir at I have "cate of consent to insure, ira c
Worker's Compen on In trance, or ereof. 3800, Labor
Policy No. .Company
Z�?,J`Copywith t city. O Certified copy is hereby furnished.
CERTIFI EXEMPTION FROM
WORKER OM EEATION INSURANCE
(This section need o e co f/ the it is /or one hund 0�
or less.)
I certify that in tt) perform a of thg work for whit hi a it i issued;
employ any arson in ny ma r so as to become sub' t t• Wo issued;
Con
•
51-420 Ilo Ilo
block wall
Sq. Ft. 170 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
`Estimated Valuation
4,250
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const. 63 . via
Mech.'
Electrica�r 11
Plum g
S.fo. .40
. a,•
Dr. vewa nc.
tructure
4, i of
• n• z
� )41..i• ... � .�; eta a, x r- 1., .+
TOTAL' 63.40
REMARKS
)) valuation
I shall not
Laws of California.
Date Own
ption you should become
NOTICE TO APPLICANT: NMfter making this CertiricWfdW.7
ZONE:
BY:subject
to the Workers' Fpensation provisionsof: de --you must forthwith.Minimum
comply with such provisions or this permit shall be deemed
Setback Distances:
_
FroAt Setback from Center Line
Sir
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
This is a building permit when properly filled out, signed'nd validated, and is subject to
FINAL DATE
INSPECTOR
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.
Issued by:
Date Permit
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.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
4'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOMESVC.
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)
LAUNDRYTRAY
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.
SO. FT. ® c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3Ac
HOUSE SEWER
FRAMING
FINAL INSP.
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 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
/Q ^ � IL,n
/ Ibl !�/
dQ ��� � /OC /C/ J /�FIREPLACE rrJl [ �/V ���///
AT
REMARKS:
VENTILATION
FIRE ZONE ROOFING
SPARK ARRESTOR
GAR. FIREWALL
LATHING�l/Y/►
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINRIALS
'
GARDEN WALL FINAL