11068 (RC)P.O. BOX 1504
Building 78-15t3 Calle +iii;-' cf� 7&105 CALLE ESTADO
AAA,... LA OUINTA_ CALIFORNIA 92253
Owner
xXZERCX LABROC
Mailing
Address 225 Santa Monica 0815
City Zip Tel.
. Santa Monical. 90401 213/458-3848
Contractor
Kretz Construction
dd res
- ,s, # Fey Norte
P.S.
State Lic.
& Classif.
rt Arch.; Engr.,
Designer
Address
92252 325-3489
City
509446 1 Lic. # 224
Tel.
CityI Zip I State I
Lic. #
LICENSED
I am licensed
the Business
icing with Section
is in full force and
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 Profess %ns Code.i Any city, or county which requires a
permit to construct, atter, improve, demolish, orf p ''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 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 than rive hundred dollars (8500).
❑ 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 notapplyto 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. 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 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 pursuant.to,the Contractor's License Law.)
O 1 am exempt under Sec. B. 8 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.)
Policyy,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 ($100) valuation
or less.)
I certify that in the performance of tha 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: If, 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= 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
ateMailing Address
City, State, Zip
No. 11066
BUILDING: TYPE CONST. OCC: GRP."
A.P.•Number
Legal Description
Project Description
Plaza Tampico. Te :ant Imp
1 &
2
Sq. Ft.
Size 2300.
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑
"Demolition ❑
Estimated Valuation .
851000
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bal.
121. 80
Const.
572.00
Mech.
60.08
Electrical
61. 00
Plumbing
75.00
S.M.I.
17.85
Grading
Driveway Enc.
Infrastructure
TOTAL
�15,� . �5
907.65
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
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:
Validati
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT. ®
YARD SPKLR SYSTEM `
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN.
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
C
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.,
io
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
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 PLUMBING1. 6k ykni
Icy UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE l(Q`
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.
C
$ plus x$
=$
LUMBER GR.
FINAL INSP.,
io
FRAMING
FINAL INSP. %
ROOFING
/r�
L/
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[/ C//�� pw
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