04916 (SFD)Building
Address
Owner
TAtyl
44.,�Gu
P.O. BOX 1504 N Q ; 04
78-105 CALLE ESTADO
4 ... j G • 5egeylajr a �.oUrt LA QUINTA, CALIFORNIA 92253
,Bar. Con Development
Mailing BUILDING: TYPE CONST.' OCC: GRP.
Address 68-713 Perez Road.Pir'e La t�e�inta
A.P. Number
City Zip ITel.
Cathedral Git5 9223 7717"9024 Legal Description '
Contractor Project Description yPlan 2017,r Lot 25
Same
Address
State Lic.
& Classif.- , 337077
Arch., Engr.,
Designer
Address
City
Lic. # Sq. Ft.2� 17 No. No. Dw'-•
Size - Stories Units
Tel.
City Zip State
Lic. #
s LICENSED CONTRACTOR'S DECLARATION
I hereby affirmthat I am licensed under Provisions of Chapter 9 (commencing with Section
7(108) of Division 3 of the Business and Professions Code, and my license is in full force and
• 'effect. ,�,y;+' �-yr'•�_.1„-^.--•--•*-M %--'-' i �.. .��.�
SIGNATURE `?a _ `• - DATE
OWNER -BUILDER DECLARATION `
I hereby affirm that I ant exempt from the Contractor's License Law for the following
reason: (Sec. 7031-5,Busrness and Professions Code: Any city, or county which requires a
New ❑ Add ❑ Alter ❑ Repair O Demolition ❑,
Estimated Valuation 1102,026
permrt o construct, alter, rrlprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
-
PERMIT
-
AMOUNT
Me provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
•
Ohnsion 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption- Any vfo/aeon of Section 7031.5 by 'any applicant for a permit
Plan Chk. Dep.
subjects the,appfcant to a civil penalty of not more than rove hundred dollars ($500).
❑ I, as owner the wm
Plan Chk.. Bal.
S 3 6 P.,w
- of property, or my employees with wages as their sole compensation,
do the work and the structure is not intended or offered for sale- (Sec. 7044, Buisness and
Professions Code: The Contractor's License
'Const.
4 Q
Law does not apply to an owner of property who
• builds or 'reproves thereon and who does such work himself or through his own employees,
provided that' such improvements are not intended or offered for sale. If, however, the ,building
Mech. M -
. ,
4 2'.:`i:0 - '
or improvement is sokd within one year of completion, the owner -builder will have the burden
`
ElectrlCdl r�.
�- , -
of proving that he did not build or improve for the purpose of sale.)
.'.Saf
❑. 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
gli
struct the project (Sec- 7044, Business and Professions Coder The Contractor's License Law
_
does not apto an owner of property who builds or improves thereon, and who contracts for
py
S.M.I.-7.1
_
S. - -
such projects with a contractor(s) ficensed pursuant to the Contractor's License Law-)
•
Grading
Y
❑ 1 am exempt under Sec B. & P.C. for this reason
-
t
Driveway Enc.
,3
• Date Owner '
Infrastructure
2,295.59
„ WORKERS' COMPENSATION DECLARATION
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.)
N
Policy No • rCompany
„ -
❑ Copy is filed with the city- ❑ Certified copy is,hereby fumished.
TOTAL
$3,3X7.$
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
,fig l"y j' r hT�`.:' ''y '. '3�f;--j Aft •r
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' Y, after mab7g this Certificate of Exemption' you should become
-
ZONE:
BY:
. subject to, the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this pemnd shall be deemed revoked. ••
- - - '
Minimum Setback Distances•.,.. -
\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 constructiomlending agency for the performance of the
- work for which this permit is issued. (Sec. 3097, Civil code.)
Side Setback from Property Line
Lenders Name
Lenders Addres s
This
- 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.
FINAL DATE
-
INSPECTOR •
. 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-.
r�
mentioned property for inspection purposes- •
• Validated by:
-
Signature of applicant Date
,
• Mailing Address
'Validation:
city, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2N0 FL SQ. FT. ®
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT.
GAS (ROUG �Z/ ETER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
GAS (FINAL) OLE
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. @
FINAL INSP.
BOND BEAM
DRINKING FOUNTAIN.
WALL SQ. FT.
LUMBER GR.
FINAL INSP. G
FRAMING (^ /
1 �
URINAL
SQ. FT. @
/
t
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MEOH.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
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUG �Z/ ETER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) OLE
GROUT
WATER HEATER ERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$_=$
LUMBER GR.
FINAL INSP. G
FRAMING (^ /
1 �
FINAL INSP.
ROOFING
/
t
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND (
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREVINITIALS
GARDEN WALL FINAL
1