003129Building
Address 51-225 Valesco Avec-me
Owner
Mailing' _
Address p. ID. BOX iii,56
City Zip
Contractor
�.�tA►r { 1Aez 4 3 rl�a+n
Address.
Tel.
P.O. BOX 1504 � � , 003129
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING- TYPE CONST. - OCC: GRP.• '
A.P.• Number, 773-064-020.
L70A Legal Description
Project Description. asAfk-f 4m"
City
Zip..
Tel
State Lic.
City
& Classif: -
Lic. #
Sq. Ft.
No. No. Dw.
Size.
Stories Units
-: Designer•
New ❑ Add C
Alter ❑'. Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION.
- -
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing'with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force'and
effect. t
.. ... . ..
.. .., .. .. .. ...
SIGNATURE DATE t
OWNER -BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for the followingg�
reason: (Sec. 7031.5,Business and Professions Code: Any,. -city or county which requires..a
Estimated Valtiatlon.
��
0
,. PERMIT
- %l,
..
-
•' - AMOUNT ----
permit to -construct. alter, improve, demolish, or repair any.. structure,,. prior to its issuance lso.
-requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of 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 penalty of not more than live. hundred dollars ($500). •'
Q.I, as owner of the property,. or. my employees with wages as their sole compensation, will
• Pian,Chk. Dep.
...
..Plan.Chk. Bal.
'
,L` f �A +�1C
do the work, and the structure is not intended or offeied:Aor.sale. (Sec. 7044,.Buisness and
Professions Code: The Contractor's, License Law does not apply -to an owner of property, who
Const....' -
f A Mf%
Mech.
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. ll„'however; the building
Electrical -
or improvement is sold -within one year of completion, the owner -builder wilf have the burden
of proving that he did not build or Improve for the purpose of sale.)
Plumbing
❑ I, 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 .
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 the. Contractor's License Law.) • ..
.. 0 I am exempt under Sec. B. & P.C. for this reason
1
S.M.I.-
_
�.
Grading
Driveway Enc.
D to fK 41.. Owner �`:*s �•r ^
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.)
' 'Policy No. Company
0 Copy is filed with the city..” ❑ Certified copy is hereby furnished. -
TOTAL
531
_
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE
REMARKS
..�.;• w.,.. '
(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 note
employ any person in any -manner so as to become subject to the Workers' Compensation'
Laws of California.
_
Date =='Owner
NOTICE TO APPLICANT: If, after making this Certificate ' of Exemption you should become
subject to the 'Workers' Compensation provisions of the Labor Code', you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances: - - -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION, LENDING AGENCY
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
Lender's 'Name
FINAL DATE
Issued by:
Validated by:
INSPECTOR
f _
Date € /1/R7 . Permit-
_
Lender's 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 1 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.
Signature of applicant Date
Mailing Address
validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SQ FT ®
HEATING (FINAL)
URINAL
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(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
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 GOND. 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 APP.IEQUIP.
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
FIN L INSP.
ROOFING
1
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL