10648 (PLBG)Building 78-630 Tujunga
Address
Owner
Daniel Duanas
Mailing
Address same_
C"la Qum nta
_1zip 92253 1
Con
Werr/auilder
Address
Zip
4
4
P.O. BOX 1504 111 U. nCAQ
78-105 CALLE ESTADO
LAQUINTA,CALIFORNIA 92253'
BUILDING: -TYPE CONST. _OCC: GRP;.
A.P. Number
564-4186 Legal Description
Project Description
Converting from propane to gas'
State Lic. City
& Classif. Lic. #
Sq. Ft. No. No. Dw.
Arch_Engr.,,
Size. Stories units
Designer
New 0 Add 0 Alter 0 Repair -E] Demolition 0
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.
DATE
OWNER -BUILDER DECLARATION
Estimated'Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
100
reason: (Sec. 7031.5,Business and Professions Code: Any city or County which requires a
.00
permit to construct, after, 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
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 Any Section 7031:5 by 'any for
Plan Chk., Dep.
alleged exemption. violation of applicant a permit
'subjects the applicant to a*cM] penalty of not more than five hundred dollars',($500).
Plan Chk. Bal.
_W, 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. .0
15 0
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,
Mebh..
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 improve for the purpose of sale.)
b 1, asowner of the property, am exclusively contracting with licensed contractors to.coa-
Plumbing 50 z
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
S. M. 1.
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
Grading
0 1 am exempt under Sec.B. &.P.C. 4or this reason
Driveway Enc.
Date 6wnerL i a,,�, P_ ;4L
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
0 Copy is filed with -the city., .0. Certified copy is.hereby furnished.
TOTAL _ 3°3.53
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not. be completed If the permit Is for one hundred dollars (5100),vatuaffor,
or less.)
I certify that in the performance of thp work for which thispermit is issued, I shall not
employanyperson in any manner,so as to become -srdbiect to'. the'Workers:.Cgippensation
Laws of California
Date' Own
NOTICE TO APPLICANT: B, after making this Certificate of Exemption you should bec6rne
ZONE: BY:
subject to the Workehj Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shag be deemed 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
FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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 Permit
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.
Validated by:
Signature of applicant -Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SO. FT.
GAS (ROUGH) 9
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
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
MESH
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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) 9
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$
_$ o
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- G/
r
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL