14703 (BLCK)• 4Q"
- - P`O. BOX 1504
Building 54-240 Shoal Gree$ LA QUINTA, CALIFORNIA AA 978-495 CALLE P253
Address ,
Owner
Rancho Capaetrano
Mailing
Address
..City Zip Tel. "
Contractor
Desert Sand Const. Rent Roth.
Address .
42151 Sandy BOX Rd.
City . Zip*
Tel.:
Be -nada Eltmes 99201 345--5490
No. 14703,
BUILDING: TYPE CONST. - OCC..GRP.-
A.P. Number
Legal Description Block Wall
Project Description 110 t ' 6" Garderall
State Lic.
City
& Classif.G29 888937
Lic. # 68,$
Sq. Ft.
No. No. Dw.
Size .•
Stories . • • -Units
Arch:, Engr.;
Designer
New ❑ Add. ❑
Alter O. Repair ❑ Demolition ❑ r•
Address
5
Tel.
_-
' City
Zip
State
s ..
Lic. #
LICENSED CONTRACTOR'S DECLARATION
yE
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, my license is in full force
and and
• ,effec..
t.
-
' 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 city or. County which requires a
' perrnft to construct, alter, 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 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). 1
O I, as.owner of the property, or my employees with wages as their sole compensation, will
Estimated Valuation
2 500.00
• -
PERMIT-
AMOUNT
. Plan Chk. Dep..
Plan Chk. Bal.
!a s!
• �ixJ
CrOf1St. .
-
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 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.) _ -
Mech. ^
'Electrical
Plumbing
• O 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 or property who builds or improves thereon, and who contracts for
• such projects with a contractors) licensed pursuant;fo the Contractor's License Law:)
- • "O I am exempt under Sec. B. & P.C. for this reason
S.M.I.- -
'
Grading
Driveway Enc.
' Date Owner
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
O Copy is filed with the city,. O Certified copy is hereby furnished.
TOTAL
$54. 00
CERTIFICATE OF EXEMPTION FROM '
> WORKERS' COMPENSATION INSURANCE
REMARKS
-
(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
NOTICE TO APPUCANT:'If, after making this CertificateofExemption you. should become
-ZONE:
,r,
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. - .. ' •
MlnlrrlUm Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line '
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED. FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is'a building permit when property. filled out, signed and validated, and is subject to
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.
I agree to comply with all cityand 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.
FINAL DATE
Issued by:
Validated by:
Side Street Setback from Center Line
Side Setback from Property.Line
INSPEC�OR�
F )�
Date / Permift
U'
7n
Signature of applicant Date
Mailing Address
Validation:
V //
f<./
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
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
FLOOR DRAIN
I MECHANICAL FEES
GRADING
cu. yd.
$. plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
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 ® 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 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
Z//FOUND'REINF.
GG
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