07126 (RR)Building
Address 52-415 Velaaw
Owner
Mr. 6 Kra. DAnial H
' Mailing
Address P. 0. Box 1234
City Zip
Palm Desett 92260 -
Contractor
ihM-Rite C.6=anv
Address..
.
_.... Dc --2 Box 6806
'City.A=* ziP 92306
State Lic.
& Classif. 384637
Arch., Engr.,
'.Designer
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
;._ No.
07126
Seamy- � BUILDING:oTYPE.CONST. • r OCC: GRP. h
A:P. Number 773-264 019
Tel. I
564,-3:Z5 X Legal Description
Project Description ite-rtrf
714 -?'63-
City
Lic. #
Tel.
LF7
_ Sq. Ft.
Size •
New ❑
'City Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION "
I herebyy.affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7_ivision 3 of the Business and Professions Code, and my license is in full force and
effects r ,
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,Bustness and Professions Code: Any city 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 rile 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 o1 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 rive 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
builds or. improves thereon and who does such work himself or. through his own employees,
provided Nat' 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
of proving that he did not build or irnprove for the purpose of sale.)
❑ 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.) -
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. '
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) valuation
or less.) .
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 to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT. ff, 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.
CONSTRUCTION LENDING AGENCY
I 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.)
Lenders Name
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 certity that I have read -this application and state that the above information is correct.
I agree to comply with all airy 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 applicantDate
Mailing Address '
City_ State, zip
ki
r
No.
No. Dw.
Units i, .
Add ❑ ; Alter❑ Repair ❑ Demolition ❑'
ZONE:--;-
BY:
Minimum Setback Distances:
Front Set.back.from Center Line
1
'
t
Estimated Valuation
r..
PERMIT
AMOUNT
Plan Chk. Dep.
1 '
Plan Chk. Bal.
`t
Const: '"
$45.00
Mech. '
Electrical
Plumbing .
S.M.I. -
.14
Grading
Driveway, Enc.
Infrastructure
j
r
j j
TOTAL
r V/7 -
REMARKS
1h4}5>� :.'t '�•4r 1 .'�,_i x'f�. #.
TO &l I WIAL
ZONE:--;-
BY:
Minimum Setback Distances:
Front Set.back.from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line `.
Side. Setback from Pro'erty,Line J
FINAL DATE _
INSPECTOR
^. Issued by:
Date 2/21/90 Permit -•
Validated by:
`t
-Validation: ••
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT.
FORMS
SEWER OR SEPTIC —ANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
I
GROUT
DRAINAGE PIPING
CARP. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
_$
LUMBER GR.
FINAL INSP.
URINAL
SO FT ®
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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
SQ.FT.GAR ® 3/ac
HOUSE SEWER
CERT. OCC.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
HMECH.FEEPL.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 —ANK
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
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