The URL can be used to link to this page

10770 (RPL)43-635 P.O. BOX 1504 No. x 0770 Buildinig 46-440—SKYWARD ��. 7&105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 OO�yyw.�pntrer Mailing Address SAME City LA QUINTA Contractor OWNER BUILDER .Address SAME City DAV I EL & I RKA ROHO Zip 92253 Zip LDING: TYPE CONST. ' OCC: GRP. P. Number Tel. 345-3222 Legal Description Project Description POOL .AND SPA 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 APPLICANT., If, after making this Certificate o/ Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shallbe deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 if work thereunder is suspended.for 180 days. I car Illy that I have read this application and state that the above information is correct.. 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. Signature of applicant Date Mailing Address City, State, Zip 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: Validation: State Lia City & Classif. Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition :1 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 Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following c $ 16 OOO reason: (Sec. 7031.5,Business and. Professions Code: Any city or county which requires a f 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 AMOUNT - the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ Division 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis for the Any. Section 7031.5 -by 'any /or Plan Chk. Dep. alleged exemption. violation of applicant a permit ' subjects the applicant to a civil penalty of not more than five hundred dollars.(8500). '. Plan. Chk. Bal. C r 1_ *a' 5 Xte l, as owner of the property, or my employees with wages as their sole compensation, will d do he work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. ?'1 O4 . Professions Code: The Contractor's License Law -does not apply to an owner of property who • • . builds or improves thereon andwho does such work himself or through his own. employees, Mech. Z:�j �ci provided, that such improvements are not intended or offered /or sale. I/, however, the building.. or improvement is sold within one year of completion, the owner -builder will have the burden Electrical -.� O.� of proving that he did not build or improve for the purpose o/ sale:) _ O I, as owner of the property, am exclusively contracting with licensed.contractors to con- Plumbing 27.00 • slruct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner o/ property-whobuilds or improves thereon, and who contracts for S.M.I. 1.60 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 Driveway Enc. %`Date 7- 1.1 Owner ' A',0'AA •� A,°:-:�,�,, r _l-- : � 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 O Copy is filed with the city. 0 Certified copy is hereby furnished. TOTAL cy379.7 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if. the 'permit Is /or 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 APPLICANT., If, after making this Certificate o/ Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shallbe deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 if work thereunder is suspended.for 180 days. I car Illy that I have read this application and state that the above information is correct.. 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. Signature of applicant Date Mailing Address City, State, Zip 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: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL. SQ. FT. ROUGH PLUMB. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ, FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® DUCT WORK DRAINAGE PIPING WALL SQ. FT. GAS (ROUGH) DRINKING FOUNTAIN. SQ FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER HEATER WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ plus x$ 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 ® 1 Vi 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 APPJEQUIP. 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 d7 U Q� / v / h/ /%� /////�� 6 " O( REMARKS: VENTILATIONif FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESHZ- INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL