04915 (SFD)4,4 a
P.O. BOX 1504 No. 049.5
Building 7&105 CALLE ESTADO
• Address' 49 '035 S'er'enatya Ivf urn LA QUINTA, CALIFORNIA 92253.
Owner
Bar Con -Development,
T Mailing
Address 68-713 Perag Ro ,A
City Zip Tel.
Cathedral tgtJ 92234 773--9024
Contractor
;aloe
Address
City IZip,
• State Lic.
& Classif: 3.37077
Arch., Engr.,
Designer-
' Address
BUILDING: -TYPE CONST. OCC: GRP.
A.P. Number Pare La. Quanta
.1 • t i 1.
Legal Description '
Project Description Plan 20279 Lot 19
City
Lic. # 1210 Sq. Ft. 2017 No. No: Dw.
Size Stories Units
Tel.
New ❑ Add ❑ • Alter ❑ Repair ❑ Demolition ❑
' City
Zip
State
•
Lic. #
1
LICENSED CONTRACTOR'S DECLARATION'
I hereby affirm that I am,lfcensed under provisions of Chapter 9 (commencing with Section
7000) of Didision 3 of the,eusiness and Professions Code, and my licenseis in full force and
-
.. SIGNATURE DATE
S '. "OWNER BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business ,and Professions Code: Any city or county which requires a
Permit to construct, after. Improve, demolish, or repair any structure, prior to Its issuance also
requires the applicant for such permit to We a signed statement that he is licensed pursuant to
• the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of -
Division 3 o/ 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
subjects the applicant to a civil penally of not more than live hundred dollars ($500).
❑ 1, 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, Buisness and
Code: The Contractors License Law does not apply to an owner of property who
builds or knproves thereon and who does, such work himself or through his own employees,
provided that such improvenenls are not intended or offered for sale. I/, however, the building ..
or Improvement is sold within one year of completion, the, owner -builder will have the burden
- of proving that he did not build or utwove for the purpose of sale.)
Estimated Valuation
$102 a 026
-
PERMIT' - AMOUNT •
� -•
Plan Chk.'Dep.
-
Plan Chk. Bal. , S 3 68 A S
Const.,
' - 440.50 '
Mech. ' ' o ty h
- - - L .�J t '
EleCtflCa ,'';
-� -- ' - 79.50 '+
_�-
Plumbing- 94.-00
• ❑ 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
S•M.1. � '
does not apply to an owner of property who builds or improves thereon, and who contracts for
. such projects with a contracto (s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. a- & P.C. for this reason
Grading r
Driveway Enc. r
Date Owner
Infrastructure 2,295'.59
WORKERS' COMPENSATION DECLARATION
" I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers 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 $3.527.62
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
REMARKS 3
'* r;(t :; ';r f, Y=it`r�,r•(••�• `_7..,}}-} .«;tg'tv,y.� , ,r �t•� ; j .'• -
'ra-
' (This section need not be completed if the permit is for one hundred dollars (8100) valuation
orless.)-
I certify that in the perfomnance of lhp 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: n, after making this Certificate of Exemption -you should become
subject to the Workers' Compensation provisions of the Labor Cede, you must forthwith
comply With such provisions or this Permit shall be deemed revoked.
i
ZONE:BY:'� '
Minimum Setback Distances:
Front Setback,from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for .the performance of the
work for which this permit is issued: (Sec. 3097, Cita code.) •
Lenders Name•
Side Street Setback from Center Line
Side Setback from Property Line'
FINAL DATE INSPECTOR
I
• I88
+Issued
Lenders Address
.
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. '
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 representatives -of this 'city to 'enter the -above,
mentioned property for inspection Purposes,'Validated
by: Date Permit
by:
Signature of applicant Date
Mailing Address
-- {
Validation:
City, State, Zip
z- •��y•/.Fk_3'�' `"'' .� rt•f, - i,rS-c'Yt" Z r
A�j w _
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
B GRADE.. —�
PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT.
/J
GAS (ROUGH) �7 �� t/
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
P. POLE
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT. @
=$
LUMBER GR.
FINAL INSP
FRAMING Q
URINAL
SQ. FT.
REMARKS:
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SQ. FT. ® c
BATH TUB
FINISH GRADING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
CERT. OCC.
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
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
VU NO PLUMBING �g
4ROUGH
UNDERGROUND
A.C. UNIT
COLL AREA
B GRADE.. —�
PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
AEUND. REINF. _ $
/J
GAS (ROUGH) �7 �� t/
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
IV REINF. STEEL
GAS (FINAL)
v
P. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP
FRAMING Q
FINAL INSP.
ROOFING rf ((( W
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Z�
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESI'NITIALS
GARDEN WALL FINAL