04914 (SFD)P.O.�44
BOX 1504 N o . 0 914
Building 78-105 CALLE ESTADO
Address 49-49'5 SBXeaaaa >Cnart , . _LA QUINTA; CALIFORNIA 92253 t
• Owner -
Bar C¢u Develoment BUILDING: TYPE CONST. OCC: GF#P. 0:
I•
Mailing
• Address 68-713 Perez Ro at$� A.P. Number PBXs. List 012inta
'CityZip Tel.
Cathedral CitSr • 92234 773-i024—___ Legal Description
Contractor' M Project Description P'>L �la� � 2 7, Lnt 2 7
Ca::cn
Address.
City Zip Tel
State Lic. - City
&Classif- 33707.7 Lic.# r i2,14 Sq.Ft. 2,017 No.. No. Dw.
Arch.; Engr.,
Size Stories Units
- • • '
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address' Tel- „
" City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that,l am licensed under DrOvisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Bu iness and Professions Code and my license is in full force and
effect.X1 j • r ..�.�--- _ ._„ /7-7
n Y
SIGNATURE - DATE
OWNER-BUILDERDECLARATION
I hereby affirm that I am exempt from the Contractors License law for the following
reason: (Sec. 7031.5,Bustness and Professions Code: Any CRY 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
Ore provisions of the Contract)r's>License Law, Chapter 9 (commerrcbug with Section 7000).of
' 4vfsfon 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Secuon 7031.5 by 'any applicant for a permit
subjects the applicant to a cM penalty of not more Man five hundred.dollars ($500).
❑ 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, Buisness and
Professions Code: The Contractor's License Law does not apply, to an owner of property who
Estimated Valuation
Q �� •
V F
-
PERMIT
- -
a AMOUNT,
Plan Chk. Dep.
-
S -a 5,
Plan Chk. Bal.
A40.. 1)
CiOrISt.
4 2. DO
Mech.
y+
' builds or improves thereon and who does such work himself or through his own employees.
provided that such improvements are not intended or offered for sale. N however, the building
Of improvement is sold within one year of completion. the owner -builder will have the burden
of proving that he did not build or improve for the purpose of safe.)
Electrical
t . {� • '
Plumbing .' .
❑ 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 contractor(s) licensed pursuant to Ore Contractor's License Law.)
'Grading
❑ 1 am exempt under Sec B. & P.C. for this reason
_
Driveway Enc.
'
Date Owner
Infrastructure
2.395. 59, .
WORKERS'COMPENSATIONDECLARATION
'\i, "• MF
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
$3,327.62
CERTIFICATE OF EXEMPTION FROM ..
WORKERS' COMPENSATION INSURANCE
REMARKS
',.' dAl� �5'kG.a! t311� ` " X ;•r :y '" �•yT .fig - .
. (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
NOTICETO APPLICANT: lf, after making this Cerfilrate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions orthis permit shall bedeemed revoked .
ZONE: _ BY:
- -
Minimum Setback Distances: -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
' CONSTRUCTION LENDING AGENCY
1 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 Street Setback from Center Line
_
Side Setback from Property Line
Lenders Name
FINAL DATE
_ Issued by:
•
Validated by:
INSPECTOR
2/19 i $
Dat Permit
.
Lenders Address
• This is a building permit when property filled out, signed and validated, and is subject to '
expiration it work thereunder is suspended for 180 days.
I certity 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 orf this city to enter the above..
mentioned property for inspection purposes. , -
Signature of applicant Date
Mailing Address
;Validation: -
City, State, Zip
✓
Vii. C�i�r Y r � y ,_ f..�.•_�.. t ,
r �t
I lye
4^ y .. _ ..,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE % S /
ROUG PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCTWORK
ROCKSTORAGE
FOUND. REINF. /
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
A FINAL) 1bMle
DRAINAGE PIPING
CARP. SO. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL SO. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SO. FT.
GRADING
cu. yd.
plus x$_=
$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
v
✓✓ //� 4/
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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 ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE % S /
ROUG PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
O
ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF. /
G (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
A FINAL) 1bMle
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 !/r l
v
✓✓ //� 4/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 4
MESH
INSULATION/SOUND
FINISH GRADING
d_�
NFI AL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESINITIALS
GARDEN WALL FINAL