04912 (SFD)Builin
Address 49-005 Tango Court
Owner
BarCon Development
Mailing
Address 68-713 serer Road "
City Zip Tel.
"atbedral Ci-ty 92234 1.773 -
Contractor
State Lic.
& Classif.
Arch., Engr.,
Designer
Address
City
I hereby affi"A
7000) of Division;
effect.
Zip
337037
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
«. y
Tela
City
Lic.# 12.19
Tel.
ZipIState
Lic. #
CONTRACTOR'S DECLARATION
under provisions of Chapter 9
and Professions Code, and my li
No. 04912
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number Farc La 4z33nta
Legal Description71 4
Project Description P I MM, 2017 « Lot 9
Sq. Ft. 2017 No. 2 No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
commencing with Section
cense is in full force and
7—f.
DATE
OWNEWBUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
$102026
$ 102 02 6
reason:.(Sec. 7031.5,Business and Professions Code: Any city or county which requires a
3
.permit to construct, after, Improve, demolish, of repair arty structure, -prior to its issuance also
requires the applicant for such permit to Me a signed statement that hes licensed pursuant to
'
PERMIT
AMOUNT
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 Any Section 7031.5 'any
Plan Chk. Dep.
exemption. violation of by applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars (E500).
Plan Chk. Bal.
r'3
❑ 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
Const.—T470—..5
0
Professions Code: The Contractor's License Law does t appy to an owner of property who
Tro
builds or inproves thereon and who does such work himself or through his own employees,
Mech.
42.00
provided that such Improvements are not intended or offered for safe. It, however, the building
or improvement is sold within one year of completion, the owner -budder wig have the burden
Electrical
79-50
of proving that he did not build or improve for the purpose of safe.)
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
94.00
- 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 'reproves thereon, and who contracts for.
S.M.I.
'
7.1-8
such projects with a contractor(s) licensed pursuant to the Contractors License Law.) -
Grading
O I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
1 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 fumished.
TOTAL
4, / r,-4.
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pend is for one hundred dollars ($100) valuation
Y�3' I'� {
or less.)
1 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 of Exemption you should become
ZONE:
BY:
• subject to the Workers' Compensation provsiors of the Lab" Code, you must forthwith
Comply with such Provisions orthis permit shag bedeemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
FINAL DATE
INSPECTOR
expiration it work thereunder is suspended for 100 days-- -'
2 f
89
12/12/
I certity that I have read this application and state that the above information is correct.
Issued by:
Date
I agree to comply with all city and county ordinances and state laws relating to building
_Permit
construction, and hereby authorize representatives of this city to enter the above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
iia
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
a
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
9
COLL. AREA
SLAB GRADE/La
YARD SPKLR SYSTEM
2ND FL. S0. FT. ®
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ER O
ROUGH WIRING
I IPOWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
/1
7
-y
GAS (ROUGH) ( 3 f� R LOOP
HEATING (FINAL)
DRAINAGE PIPING
CARP. SO. FT. @
GAS (FINAL)
WALL SO. FT.
DRINKING FOUNTAIN.
GROUT
URINAL
SO. FT.
SERVICE
ESTIMATED CONSTRUCTION VALUATION $
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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING (
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
t
//O o
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/. c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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
PLUM BI JG —
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE/La
ROI G PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER O
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. `
/1
7
-y
GAS (ROUGH) ( 3 f� R 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. 7 /G6%
FRAMING N
FINAL INSP.
ROOFING (
w
fJ �C%�V%r�'j/j'"
U
t
//O o
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
1