07208 (BLCK),Building
Address 54-'640 VelasM
Owner
Jamas MbDan►ald
Mailing
AddresstTt8P.
City Zip
Liet QuInt.a 92253
Contractor
. Address.
44-
P.O. BOX 1504 No. 07208
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: •TYPE CONST. - OCC: GRP.-
A.P.
RP. A.P. Number 77$-284-010-'427
Tel. •
5 _� 901 h Y Legal Description
Project Description 62' X 6' block mall
l°Ity
Llp
1 el..
.J
State Lic.
City
& Classif.
Lic. #
Sq. Ft.
No. No. Dw.
Size •
Stories Units-
" Arch., Engr-, . .._
....
Designer
New ❑ Adds❑-
Alter ❑ Repair ❑ Demolition 0 -
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. •
SIGNATURE DATE
-
' OWNER -BUILDER DECLARATION'.,Estimated
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
Valuation
Q sstt
YllaQ�
reason: (Sec. 7031.5,8usirress 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
PERMIT "'
AMOUNT .
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
Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
❑ 1, 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, Suisness and
Const.
$45.00
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or irrproves thereon and who does such work himself or through his own employees,
Mech.
'
- provided that such improvements are not intended or offered for sale. ff, 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 bmTd or Bmprove for the purpose of sale.) .
❑ 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.I.
t`
•14
' such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
-
Grading
O 1 am exempt under Sec B. & P.C. for this reason
i-
Driveway Enc.
Date " Owner p:.w_ �'?-��► ti C 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
/ f
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
✓ . /
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKSa
"s:r�•tt �'.
WORKERS' COMPENSATION INSURANCE
r'�r��`f
4 �," • „ w ;
is section need not be (This completed if the pemrit is for one hundred do8ars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
-
employ any ppeerso
Laws of Californian in any manner so as to become subject to the Workers' Compensation
Date' dwner"
"
NOTICE TO APPLICANT ff, after making this Certificate of Exemption you should become
'
ZONE:
BY: -
subject to the Workers' 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
1 hereby affirm that there is a construction lending agency for the performance of the.
work for which this permit is issued. (Sea. 3097, Civil code.) -
Side Setback from Property Line
Lender's Name
Lenders Address
FINAL DATE'
INSPECTOR
This is a building permit when property filled out, signed and validated, 'and is subject to. '
'2/26190
expiration if work thereunder is suspended for 180 days.
1 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
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
_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. ®
WALL Sp. FT.
WATER HEATER
DRINKING FOUNTAIN.
FINAL INSP.
URINAL
SO FT ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
INSULATIONISOUND
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 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