Loading...
10811 (MISC)TW* �. 4P.14 O.4 / N o . 10811 Building.52-65a 9EL�SC4 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Mailing C: •'� ®HN BETH MONTENEGRO BUILDING: TYPE CONST: �J OCGRP, Address SAME A.P. Number City Zip Tel. LA. Q.UINTA $2253. 564-4160 Legal Description Contractor -"INSTALL GAS LINE' 100 • OWNER BUILDER Project Description Address .. SAME City Zip Tel.: State Lic. City & Classif. Lic. # �, Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ "Demolition ❑ Address I Tel, City I Zip I 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: _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 cHY or county which requires a permit to construct, atter, improve; demolish, -or repair any-stnrchue, prior to its issuance also requires the applicant for such permit to Me a signed statement that hes 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,:fhan five hundred do0ars.(f500). 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 appy to an owner of property who - 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. lf, however, the building or improvement is sold within one year. of completion, the .owner-buWar will have the burden . of proving that he did not build.or improve 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 purrsluant to the Contractor's License -Law:) O 1 am exempt under Sec. /B. & P.C. for this reason (3-2Owner ?a^ f .rI.1j1 j;( ;'t t� r' WORKERS' COMPENSATION DECLARATION y I hereby affirm that I have a'certificate'of consenf'to self -insure, or a certificate of Wrke or s.Compensation Insurance, or.a.certified copy thereof -(Sec. 3800,. Labor- Code.). Policy No. Company i s ❑ 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 ($100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any PPerson in any manner so as to become subject to the Workers' Compensation Laws of California. r• J' t fj0ate =/' �!% Owner .'` ~ / '" i � J' , r " ; r • -jr.....I, c L, ,, ,_-"".,. NOTICE TO APPLICANT: If, after making this Certificate of Exemptionyou should become subject- tb the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this pemdt 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.) Lender's Name Lender's Address This is a 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. 1 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 City, State, Zip l_ ZONE: BY: Minimum Setback Distances- ' Front. Setback from Center Line y Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date - ' '- Permit Validated by: Validation: Estimated Valuation $150 PERMIT AMOUNT .Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing $30.00 S.M.I. . Grading Driveway Enc. Infrastructure TOTAL §.10.00 REMARKS ZONE: BY: Minimum Setback Distances- ' Front. Setback from Center Line y Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date - ' '- Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CARP. SO. FT. ® GAS (ROUGH) y d DRAINAGE PIPING WALL SO. 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.COQL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED. LAUNDRYTRAY AIR HANDLING UNIT CFM REMARKS: KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY r 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 ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® V.c HOUSE •SEWER MESH 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 N ROUGH WIRING. DUCT WORK ROCK STORAGE F 'FOUND. REINF. GAS (ROUGH) y d 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 -4< CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL