11610 (BLCK).t
fix•' f T . �. .
.. P.O. BOX 1504 N o . 1161.0
Buildisy ` `° ' ' ` 78-105 CALLE ESTADO
Address 51-.225 Avenida VelaSCO LA QUINTA, CALIFORNIA 92253
Owner
Scott P. Russell
BUILDING: TYPE CONST.' OCC: GRP.
Mailing
Address 51-2-25- Avenida Velasco
A.P. Number
City Zip Tel.
La• Qusnta," CA - 92253 56404088 Legal Description
Contractor! Project Description 701 C3: 61 h�.�h' * block wall in
Owner/Builder
Address rear of house."
I 1 is
City Zip Tel.:aF�(�ti ,gf At i
J
State Lic. City r y t `► ,
& Classif. f Lic. # Sq Ft,�.fc `No ... -, No. Dw.
Arch. n r '
:Si '-- = rSr Stories- Units
Designer New .0 ` "f Add ❑ Alter ❑ Repair Demolition ❑
Address Tel.
CityZip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION t .
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Divisio 3.of.the•Businessand °Professions ode and my license is in full force and
SIGNATURE 1 DATE • -
OWNER -BUILDER DECLARATION 1.
Estimated Valuation t
I hereby affirm that I am exempt from the Contractor's. License Law for the fohoWing $1 , 750. 00 _
reason: (Sec. 7031.5,Business and Professions, Code: Any. city oreco_unty whlch,,regWies a
..4 permit to construct, alter, improve,, demolish, - or repair any structure,+fprimo fo it�sOlssuance also -� • • '
requires the applicant for such permit to file a signed statement that /ietis licensed'pursuant to - :PERMIT, "AMOUNT =
the provisions of the Contractor's License Law, Chapter 9p(Eommen t g wltfi Secllon' 7000) of r • ., -
Division 3 of the Business and Professions Code, or thatfhe is exeMp�tlierefrom, and the basis ,
for the alleged exemption. Any violation of Sectform-7031.5. by,'any:.app1icant for a permit -Plan Chk..Dep. -
' subjects the applicant to a civil penalty of.not moreit�tiv
n�e hundred.dollars.($500).
O I, as owner.of the property, or my employees with wagesras.their sole compensation, will, >
'Plan Chk...Bal.
,do the work, and the structure isnot intended or offered for sale: (Sec. 7044, Buisness and 45.'00 1lqq
Professions Code:, The ConGactor's''1Ucense Law: doeslnaf apply'. to an owner of property. who Const. 45 00
builds or improves thereon and `who" does such work himself'or through his own employees, Mech.
provided that such Improvements are not intended or offered for: sale. If, however, the building
or improvement is sold within one'year bf compleffon,- the owner -builder will•have-the burden Electrical c of proving that he did not. build or improve for the. purpose of sale.) -
µ f7 I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing. .
struct the project. (Sec. 7044,•Buslness 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. - - e 20
such projects with a contractor(s) licensed pursuant to the Contractor's -License Law.) - - -
Grading
,. ❑ 1 am exempt under Sec. B. & P.C. for this reason
s _ Driveway Enc.
Date rf f•�/' Owner .— � � ' ` Infrastructure
WORKERS' COMPENSATION DECLARATION
I 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.) v . r . „ _ ,,,, t �•
Policy No.—.Company er a: }.ti i�• f GSL. , .{ } x' r i7j
O Copy is filed with the city. r Q Certified copy is hereby furnished..
TOTAL
CERTIFICATE OF EXEMPTION FROM f) REMARKS
WORKERS' COMPENSATION INSURANCE. �'+tEitf`•
(This section need not be completed If the permit is for one hundrted dollars(($100) valuation
or less.) .1 1
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject toAhe Workers' Compensation
Laws of California.
NOTICE TO APPLICANT r If, after making this Certificate of Exemption' you should become ZONE: - BY:-
- ' subject to the Workers' Compensation -provisions -of the Laboi Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit'shall. be deemed revoked.
K� Front Setback from Center Line -
' Rear Setback from Rear Prop. Line
CONSTRUCTION LENDINGJAGENCY Side Street Setback from Center Line
Ihereby 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.Llne
Lender's Name
Lender's Address
-This is a building permit when properly filled out, signed and validatedrand 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 witfi 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
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM 1'
POR SO FT ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL S0. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM, FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
/ I
'''' /►����C� �i,.
l 0. ti �t✓'-e r
F_'eTt. q s
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
SPARK ARRESTOR
SO. FT.® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE f::M:E:CH.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 (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM ?j
✓
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
/ I
'''' /►����C� �i,.
l 0. ti �t✓'-e r
F_'eTt. q s
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION - ?2_
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS"
GARDEN WALL FINAL
Attention Property.Owner: �.
An owner-builder_ permit,has.been applied for in ,,your name. and
bearing your signature.
Please complete. and return this information 'at your earliest
opportunity to avoid unnecessary delay in processing",and,,issuing
your building 'permit. 'No building permit will be issued until
this verification is received.
1.•,•I personally plan to provide the major labor and materials for.
construction of the proposed property-improvement (yes or no)
2. • I (have/have not) 14vK_, signed an application for a
building permit for the' proposed -work'. a
�.
S. I.have contracted-with•the.following person (firm) to 'provide.
the proposed construction:. g ,
Name-
.-.Address
ame ._ Address City '
Phone Contractors License No.
4: I' plan to• provide portions of the work, but. I- have, hired the
following person to coordinate, supervise and provide' the major.
work:
Name
Address .,� City
Phone - f Contractors License No.
5. 1 will provide some of.the.work but I have contracted,(hired)
the following persons to,provide the work indicated: (see attached)
OWNER-BUILDER SIGNATURE
RPT1
10
Rafter Size 6 Spacing
Foof Pitch Fj_uL
-Continuous Ledger
Neeler _-yx 1
Size
Rafter Spon
"fid( 18r511 C m -
14A Y_
fee toofing Note Bales
- fpetifj Roofing 6 Sheathins or Cyan Lattice
1Q�1-�Ql�
P.L.
V
Jr10
r-
200.
7 i
6-5
6"s6"xl"sl/6" with
Z
2x5
10
Rafter Size 6 Spacing
Foof Pitch Fj_uL
-Continuous Ledger
Neeler _-yx 1
Size
Rafter Spon
"fid( 18r511 C m -
14A Y_
fee toofing Note Bales
- fpetifj Roofing 6 Sheathins or Cyan Lattice
1Q�1-�Ql�
P.L.
' m C)
81 ' Jot Qe or Solid Blocking
.r.
6<NM 10to blocking
ril C*L 03
> 4 - 16 d nails or bolt _J
-0 W"4*L•! INS Imbed Anchors 7" in cone. —
�E
m 46•J.
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li:'.a w J1CO 46
w �S•
FA ISR SPAN WkME to tir Nod's 6,s k.•
cradi_nq Rules
PS 20-:0 ►4� ti +4 �4~ d��
2x4
V
and Angle Straps
r-
200.
7 i
6-5
6"s6"xl"sl/6" with
Z
2x5
4-16 d smile or holt
17=10
__,
Post spacingy
13-7
Cr
�...
Y
16-3
him. 12":12"
overall lecSth
o
8-8
.;�/ _
w
-•
P1 '.L
r!; �1
12-4
-Nin. 4"s4" posts
screws into studs at 16" D.C.
Continuous Ledger
teles Grade
' m C)
81 ' Jot Qe or Solid Blocking
.r.
6<NM 10to blocking
ril C*L 03
> 4 - 16 d nails or bolt _J
-0 W"4*L•! INS Imbed Anchors 7" in cone. —
�E
m 46•J.
�•
li:'.a w J1CO 46
w �S•
FA ISR SPAN WkME to tir Nod's 6,s k.•
cradi_nq Rules
PS 20-:0 ►4� ti +4 �4~ d��
2x4
V
-' 0
r-
200.
7 i
6-5
6-3
6-9
6-4
5-2
2x5
12" c.c.
17=10
__,
.i. ca�eete 1
13-7
Cr
�...
16' •
16-3
him. 12":12"
11-3
�`
8-8
Footing 12"
-•
P1 '.L
r!; �1
12-4
x •
screws into studs at 16" D.C.
Continuous Ledger
teles Grade
' m C)
81 ' Jot Qe or Solid Blocking
.r.
6<NM 10to blocking
ril C*L 03
> 4 - 16 d nails or bolt _J
-0 W"4*L•! INS Imbed Anchors 7" in cone. —
�E
m 46•J.
�•
li:'.a w J1CO 46
w �S•
FA ISR SPAN WkME to tir Nod's 6,s k.•
cradi_nq Rules
PS 20-:0 ►4� ti +4 �4~ d��
2x4
16' 0.c.
24-
11-2
9-0
10-6
8-8
7 i
6-5
6-3
6-9
6-4
5-2
2x5
12" c.c.
17=10
17-5
13-0
13-7
10-0
16' •
16-3
15-1
11-3
11-9
8-8
24' -
13-3
12-4
9-2
9-7
7-1
32- -
10-10
9-11
7-6
7-6
54
2x8
16' c.c.
21-5
19-101154
11-0
24- -
17-6
16-3
110j
112-8
9-4
1
32• -
14-5
13-0
-:O10-2
7-6
T-vT 4 44; Qa!Krw
0 -strap or
Angle
won -corrosive.
p !' plate
f . I 6..
• ` , fes! Crane •'s
douglas fir N0,1
size 61par1 51t.e 4P*4
4x4 .... _ _ _ 5, Y ti 4 & _
Anchor
bolts
111 f ,
c iv
�� .. ,17' ►� s12 17.'
4x14..... .20, Y, 1,4 lu-
• �, t� 14•
6x10..... 18' .6'L 10
14
Famfiaq Note
a. hood stakes 4/12 pitch (3/12 min. pitch w:th 300
felt underlay) Class A
D- Bond, carp0sitiOn shingles 4/12 pitch (3/12 min.
pitch with 151 felt underlay). Class A
c. BLilt up rolled roof slope to drain.
d- Rick roo: 3/12 mix•sn pitch.
F0250-14.3 (R12/87) OR)
Mo T Foam z > poe 7,4-nc,
COVE.,
MMIChTI P11170 CM11a
U e lOISC L
1% 1
IN