04188 (SATT)Building
Address
Owner
TAh
79-395 Tera gotta Ct. u
4.4Q
"P.O. BOX 1504'
78-105 CALLE ESTADO
QUINTA, CALIFORNIA W253.,
BUILDING: TYPE CONST. OCC. GRP.
mailing
Address 777 S. Main St.'f, S"Uite' 1=06 , _ ..62,3+'- 790 -01OV
A.P. Number -
City Zip Tel
or�tc�}0 92686 73x',54? --8456 Legal Description 'y
Contractor SWW Project Description Building 12, Plan 2
Address
' 0,4188 ,
i
City
State Lic.
& Classif.
Arch., Engr.,
Designer
Address
Zip Tel
City
462814 Lic. #� -_ . y Sq. Ft. 91,2 No. No. Dw..
Size ` ` Stories� Units
New ❑ Add ❑ Alter ❑ Repair ❑ ;o' Demolition ❑
Tel. Garage included
City " (Zip (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I heieby.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
SIGNATURE DATE
•a:,.p.
OWNER -BUILDER DECLARATION
I hereby affirm that'( am exempt from the Contractors License Law for the following .
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
Estimated Valuation 1.
$65,225
permit,to construct, atter, 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
- r. 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 for
Plan Chk. Dep..
'
alleged exemption. violation of any applicant a permit
• subjects the applicant to a civil penally of not more than five hundred dollars ($500).
Chk. Bal.
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
,Plan
do the, work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Cor1St.�.-tipt
ri
'
• 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,
Mech.
��
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 -
11 �� %�y
of proving that he did not build or improve for the purpose of sale.)
' ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
'75,00
' 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 improves thereon, and who contracts for
S.M.I.
ti
4 fi 59
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.-
nc.-Dateowner
Date-Owner'
Infrastructure
gL" ng$3"` oed 'Ll zard 33`3 • Ia.,
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
42#272071 -
CERTIFICATE OF EXEMPTION FROM,
REMARKS
f
WORKERS' COMPENSATION INSURANCE
(This section need not. be completed if the permit Is for one hundred dollars ($100) valuation
�F": �y y P�-��'6 y AA�
;,' Wµj ,F3a F ? Y;t.dT. .stip 1, NYi�, .^t3. 3J� 111
or less.)
•-71
I certify that in the performance of thg 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 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 Line
r
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'sAddress
FINAL DATEIINSPECTOR
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.
6/29/90
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
a
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
WHITE FINANCE, PINK - APPLICANT, GREEN- BUILDING, GOLDENROD - ASSESSORS OFFICE, HARD COPY -
ILE j
r t
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
ISI FL SO FT rp S
UNITS
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SO FT. a
DUCT WORK
ROCK STORAGE
OUND. REINF. ( Z"/f-
MOBILEHOME SVC.
BAR SINK
POR SO FT a
r REINF. STEEI.�Q/L
GAS (FINAL) TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR SO. FT. of
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CARP. SO FT, id
LUMBER GR.
FINAL INSP.
A 2 Z
FINAL INSP.
DRINKING FOUNTAIN
WALL SO. FT. (d
REMARKS:
URINAL
SO. FT. 0
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
WASH ER(AUTONDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
MESH
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
CERT. OCC.
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID g 1'A c
SEWAGE DISPOSAL
INSPECTOR'S SIGNATURPSlINITIALS
SO.FT.GAR @ V c
HOUSE SEWER
GARDEN WALL FINAL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
M.ECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR
SETBACK
OUND PLUMBIN-/-7 —/z UNDERGROUND
A.C. UNIT
COLL. AREA
AB GRADE '/ (�b�
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
OUND. REINF. ( Z"/f-
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
r REINF. STEEI.�Q/L
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
S plus xS
=S
LUMBER GR.
FINAL INSP.
A 2 Z
FINAL INSP.
DOPING _ $
%�/. CIC
�v ��l �✓�// /�`
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
L -AT G
MESH
NS LATIONISOUN Z�Z
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURPSlINITIALS
,
GARDEN WALL FINAL