14668 (BLCK)Building
Address . 53-940 .Avenida.
Owner''
Nark Ratzmaw
Mailing
Address p,O.Box 1613
City Zip
..La-QuiAta. 92253
Contractor .
Aon Haste Hasow..
Address
0itim Des.erg. IZIIg2260
State Lic.
& Classif..08$016
Arch., Eng .;
Designer
P.O. BOX 1504
78-495 CALLE TAMPICO
la.sco LA QUINTA, CALIFORNIA 92253
el. -
564-6530
773-4416,
City
Lic. # 2969
BUILDING: TYPECONST.• :OCC..GRP.
A.P. Number
Legal Description '
Project Description 7010 of 5' Garden Wall
Sq. Ft.
Size
New ❑ 'Add'O.: Alter ❑-
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that lam 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 Estimated Valuation 1A/�..
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
�16 V V'
reason:,(Sec.. 703.1.5, Business 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 file a signed statement that he is licensed pursuant to,, PERMIT
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. lora a permit. Plan Chk. Dep. -
subjects the applicant to a civifpenalty of not more than five hundred dollars ($500). •. ' , `
.O I, as owner,of the property, or my employees with wages as their sole compensation; will.
Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code:- -The. Contractor's. License taw does not apply to an owner or property who
Const..-,
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.sate. If, however, the building
' Mech. -
or improvement is sold within one year of completion, the .owner -builder will have the burden
of proving that he did not build or unprove for the purpose of sale.)
Electrical— -
'
Plumbing -
-b 1, 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 contractors) licensed pursuant to the Contractor's License Law.) - -
• ❑ lam exempt under Sec B. & P.C. for this reason
,.
S.M.I.
Grading
/7...,...,,
Y
ate owner Ail r� r.C1 �"c''v�..^ry.
IX. !
Driveway Enc.
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.)
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
Policy No. Company
Side Setback from Property,Line
• . ❑ Copy is filed with the city. . ❑ Certified copy is hereby furnished. -
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE - '
(This section need not be completed if the permit Is for one hundred dollars ($-100) valuation - -
: or less.)
I certify that in the performance of the 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
No. Dw.
Units
Repair O .
. NOTICE TO APPLICANT: N, after making this, Certificate % of Exemption you should become
ZONE:
subject to the worker's' -Compensation provisions of the'.Labor. Code, you must forthwith .
comply with such provisions or this permit shall be deemed revoked. -
-BY:
Minimum Setback Distances:'
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE -IS UNLAWFUL, AND
Side,Street.Setback Center Line -"
SHALL SUBJECT AN EMPLOYER'TO CRIMINAL. PENALTIES' AND CIVIL FINES UP TO ONE
.frOm
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback from Property,Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES.
' a
This is'a building permit when properly:filled out, signed-and.valitlated; and 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 with all city -and county ordinances and -state laws relating to building. ••
i
construction, and hereby authorize representatives of this city to enter the , above-.
n
mentioned property for inspection -purposes.
Validated by: •
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
�. (�
LB -0
"i.
L
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SOT.
HEATING (ROUGH)
STORAGE TANK
�
MOBILEHOME SVC.
BAR SINK
POR. SO. FT.
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT.
GAS (FINAL)
WALL SO. FT.
DRINKING FOUNTAIN.
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
S✓
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$.-Plus-x$-=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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
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/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
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./EOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM j
S✓
WATER SYSTEM
GRADING
cu. yd.
$.-Plus-x$-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
j
/ � Z/��/��
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL