003841 (BLCK)Building,
Address .51-57
Owner
P.O. BOX 1504 -No.
78-105 CALLE ESTADO
U= VEL"M LA QUINTA, CALIFORNIA 92253
BARUM WITH
...Mailing
Address 51-575 VZUSCO
City
Zip
LA QUINTA- - l92253
Contractor
. . .
Address
City'
State Lic.
& Classif.
-Arch.,'Endr.;
Designer
Zip "
564-0413
. . . I Tel'.
Lic. #
BUILDING: -TYPE CONST. OCC: GRP:
A.P. Number 77'A01'Aq_n1 S
Legal Description LOT 3 DWGK .52 UNIT #5
Project Description WOOD MICR
R
7—
Sq. Ft. No. No. Dw.
-size -Stories.. Units
New 0 Add 0. Alter 0, - -Repair 0. Demolition 0
Address Tel.
City Zip State
Lic: #
LICENSED CONTRACTORS 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
_SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason:, (Sec. 7031.5,Business and Professions Code: -Any city or county which requires a
.P _
permit to construct, alter, improve, 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
the provisions of the Contractor's License Law, :Chapter 9 (commencing with Section 7000) of
Estimated Valuation
-PERMIT AMOUNT
Division 3 of the Business and Professions Coda7, or that. he is -exempt therefrom, and the basis
for thealleged exemption. Any violation of Section 7031.5 by 'any applicant for -a 'permit
Plan Chk. Dep,
subjects -the applicant to a civil penalty of -not more than five hundred dollars,($500).
Chk. Bal.
0 1, as owner of the Property, or my employees with wages.as their sole compensation, will
...Plan
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 9wner.9f property whoConst.
(M
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 of completion, the owner -builder will'have.-the burden
Electrical
of proving that he did not build.or improve for the purpose of sale.)
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing•
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
S. M. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0 1 am exempt under Sec.B. & P.C. for this reason
Driveway Enc.
Date _"�-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.).
Policy No. . ccmpany
[JCopy is. filed with the .city. .. 0 Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
-7—
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for .one hundred dollars ($100) valuation
orless.)•
I certify that in the performance of thp work for which this permit is issued, I shall not
employ any person in any manner so as 4o -become subject to the Workers' Compensation*
Laws of California.
Date_LL ---' Owner
• NOTICE TO APPLICANT. If, after making this. Certificate of Exemption you should become
ZONE:-
BY:
subject to the Wdikers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions, or this permit 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 construction lending agency for the performance of the
• work for which this permit is issued. (Sec. 3097, CivilCode.)
Side Setback. from PropiMy Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
building permit when properly filled out, signed and validated, and.is subject to
expiration it work thereunder is suspended for 180 days..
I certify that I have read this application and state that the above information Is correct.*
IssuedDate
by
11111 VtQ Permit
I agree to comply with' All city' and county ordinances and staWlawd 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
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
FOR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK r
GAR. SO. FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APP.IEOUIP.
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
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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
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.IEOUIP.
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
FINAL INSP.
ROOFING
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