14688 (BLCK)qTAb
P.O. BOX 1504 NO: 14688
Bui;ding78-495 CALLE TAMPICO
Address 77-360 Calle Tecate LA QUINTA, CALIFORNIA 92253'
Owner ° BteYIY.i' g Homes
•Mailing " -
BUILDING:- TYPE CONST. '• • • OCC: GRP. -
Address -P.O* Box 450
A.P. Number
.City : Zip Tel.
.La. Qui ta, CA � X53 564-1866.. Legal Description
Contractor'
'150-,' 3f. 5' high a'E�+v A bl.)Ck/
Lender. Venttin�s ' Project Description �
Address
Plaster 24' ' of 4' high of swue
.Same
City . Zip TO.`
State Lic. City
& Classif. _ B 6.38525 Lic. # 859 Sq. Ft. No. No. Dw.
Size Stories - • Units
Arch., Engr., . ... .. ... �
Designer New ❑ Add ❑ - Alter ❑ Repair ❑ . Demolition ❑
Address Tel.
,City Zip State
r . L-ic,-#
LI ENSED CONTRACTOR'S DECLARATION
I hereby affirm That I amflicensed under Iirovisionsof Chapter 9 (go mencing.with Section
7W1 of Dii'vis..ion 3 of therBusiness and' Professions Code, and in license Is in.full force and:
effect. $
SIGNATURE If .-._"-••••.d7w.A-XA-F":..,A+.•.tE1 R"r AR, IF4 DATE _ -
OWNER -BUILDER DECL!ARATIONr 1;, ..
Estimated Valuation $34 528 00
I hereby affirm that 1 am exempt from the Contractor's License Law for -the following .
reason: (Sec.•f7,031.5,Business and Professfo Code:. Any city or county which .requires a
permit to constrocL atte4 improve, demolish or repair any structure, prior to its. issuance also - I -
requires thelapplicant for such permit to J�fe' a signed statement that he.is licensed•pursuant to PERMIT AMOUNT
the provisions of the Contractor's .Ucensd Law, Chapter 9 (commencing with Section 7000) of
Division 330! the Business and Professf�ns Code• or that. he is exempt therefrom; and the basis
for the alleged exemption. Any vhlation o! Section 7031.5 Dy any applicant for a permitP.lan Chk. Dep.
subjects the applicant to a civil penally of not more than rive hundred dollars ($500). -
❑ 1, 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, Suisness and 3
Professions Code: The Contractor's License Law does not COr1St
apply to an owner of property -who . 63.00
builds or Improves thereon andwho does such work himself or through. his own employees, 'Meeh.
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 Electrical -
of proving that he did not build or knprove for the purpose of sale.)
b I, as owner of the property, am.exclusively contracting with licensed contractors to con- Plumbing
Strutt 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.
such projects with a contractors) (rcensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec B. 8 P -C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure t
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a'certificate of consent to self -insure; or a certificate of
Worker/'s Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.) .
Polic No. Company '
5�1�7Copy Is filed with the city,'.. ❑ Certified copy is hereby furnished..... .
TOTAL 63.00
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'lhe Workers' Compensation
Laws of California.
NOTICE TO APPLI ANr
T:N, after making this Certificate of Exemption you should become ZONE:
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 Urie
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGEISUNLAWFUL;AND Side Street Setback from Center Line
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, . Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, -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 -�PerrnI' n
I agree to comply with all city and county ordinances and state laws relating to'building
C
onstruction, and hereby authorize. representatives -of this, city to enter the 'above-: t� • L
mentioned property for inspection purposes. Validated by- I
Signature of applicant Date' Ory �nq�
Mailing Address Validation: I FEB(" C D / `5
City, State, Zip U
Rye•
' • _ L C
a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES 1
1ST 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
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT.
GAS (FINAL)
WALL S0. FT.
DRINKING FOUNTAIN
SO. FT. ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
4 _ /
i„/,/
!/"
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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✓a c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/.c
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 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
4 _ /
i„/,/
!/"
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL