9919 (PLBG)Building
Address 77620 TEMECULA
Owner
WM. T. BUPPIN
Mailing
Address P 0 B0$ 1.34
Cityzip
QUINTA 292253
Contractor
RVS PLUMBING
Address
44757 SAN JUAN
.City PALM DESERT Zip 92260
State Lic.
& Classif. 602396
Arch., Engr.,
Designer
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
564-8470
41-6546 • I
r
No. 9919
OKUP
BUILDING: -.TYPE CONST _!_ OCC: GRP
A.P. Number
Legal Description
Project Description SEWER HOOKUP
Lic. # 1914 Sq. Ft. No. No. Dw.
Size Stories Units
Tel.
City( Zip ( State
Lic. #
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
permit to construct, alter, 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
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 five hundred dollars.(E500).
O 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 not apply to an owner or 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 or completion, the owner -builder wig have the burden
of proving that he did not build or improve for the purpose or 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.)
0 1 am exempt under Sec. B. & 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.)
Policy 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.) �t--q,,
1 certify that in the.performanc_e of therwoYk for Which this oestrilths issues. I shall not
Date i' //� ��i�✓'
NOTICE (T0, fAPPLI •AN� 1l a(fe-maktn this' Certif 'c�toe% of Exemption you should become
subject to the Workers' Compensation provisions off.t/ie •ebo-Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby 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 certify 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 tobuilding
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
a
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
(Estimated Valuation $130 0 ock
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
$30.00
S.M.I.
Date Permit
Grading
Driveway Enc.
Validation:
Infrastructure
�7
w a
x.41
TOTAL
$30.00
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:
Validation:
�7
w a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
i•
2ND FL. SQ. FT.
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.
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.
$ plus x$ •
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
FIREPLACE
SQ.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
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^re
OUGH 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 INS, P.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION 7
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
COACHELtA VALLEY WATER DISTRICT
CASH RECEIPT DETAIL N2 34992
�6 76
Received From: .L_ l U���
-
���L.��1 �jv�-
Date.r—`
Address: �' �!�13L4
t49 Lt aa A— 2 2_,C
Acccur•.t No.-n� �.�,,,
�� G�+c—�� 51;' LOt sI �`� Ti—act ct �81-gService
Address -7
.2LQ CALLr_\jBAtE:C_u LA- • G.A. code
D Meter(s)
$
C Service(s)
C Backflows)
C House Lateral (s)
C DetectorCheck(s)
Meter Surcharge
anitation Capacity Charge
o/_ _�_� . 1575
C W.S.B.F.C.
u Temporary Construction Meter
C Turn on Charge
G Uncollected Account - Name
C. Inspection Fee - Tract -
Fee -
_
Plan Check Fees Water I Sewer -
I
i Tract -
C Bond Payment - A.D. -
Bond
Assmt.
C Customer Deposit
- Other
TOTAL $ C5cS
Remarks: � � �i /Q/ �'( t: c(J i L L %'nAl c 9£rTI%10 A I
C Copy to:
Cash
Water Service
Check
i
-
Money
Order
/ Cashier
�.
CVWD-438 (11189)
-
Po LLIABOX M T BOFFIN 152
LA QUINTA, CA 92253
78-957/914
PAY TO THE / —VV
ORDER OF
(/`.l
�LD
LLAR5
NOT
NOT VAI FOR LESS THAN $100.00
CI TI BA N<O I. M
P.O. BOX 6000 .
(SOUTH DAKOTA),'N.A. SIOUX FALLS. SO 57117
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11:09 LLeo 9 5 7 11: LO 1940 380904811'0 2