09070 (SFD)c Tit
- M
P.O. BOX 1504 N o . 090TO
Building 78-105 CALLE ESTADO
'Address -79-565 STAR FLOVER ' TRAIL LA QUINTA, CALIFORNIA 92253 • ' TEMP . POWER
Owner .- Pt3 ►L$ , ,
,9..G. WILLIAMS OR9' CORP. BU
Mailing LDING: TYPE CONST.' OCC: GRP..
�''"
Address 42608 COOK ST.'. STE. #135 M A.P. Number t '
CityZipTel:
-PAIN- DESSE JA9`2'
26.0 345-7561 Legal Description LOT 69,
Contractor Project Description TERPPOVER POLE.- LOT'49
id' 35 ViiiRLOPMRUT CORP0�$ AMP POLE'
Address
62600 COOK S _. E_ 13 FOR CACTUS FLOWER SOUT19. TRACT 242.0$
City - Zip Tela
T.MR -7 C1 A Q91AA qA — t
State Lic.. City r ;
& Classif. Lic. # Sq. Ft. No: No'Dw. ;Y`Y
Size Stories Units -
Arch.; Engr.,:
Designer, '" New ❑ Add ❑ Alter ❑ Repair❑ :; ;;.Demolition ❑
Address Tel.
City . Zip State'
Lic. # '
�LrCENSED 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. m
SIGNATURE/!DATE
3 OWNER -BUILDER DECLARATION Estimated Valuation
r; I hereby affirm that I am exempt from the Contractor's License Law for the following
1
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 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 exemption. Any violation of Section 7031.5 by.'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars (8500).
.O I, 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, Buisness and Const. 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
of proving that he did not build or improve for the purposeof sale.) ,
O 1,, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ti
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. -
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - -
Grading
O 1 am exempt under Sec: B. & P.C. for this reason
Driveway Enc.
Date owner 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, ora certified copy thereof. (Sec. 3800, Labor Code.)' d
i6y No-.
PoIpany
0 Copy is filed with the city.omO Certified copy is hereby furnished: 43 r 3 - .T tt iw " 3� 'Jo
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS s
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.) -
. 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 Ownar
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 Minimum Setback Distances::
comply with such provisions or this permit shall be deemed revoked. -
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 180 days.
I certify that I have -read this application and state that the above information is correct. Issued b - 'Date Permit '
I agree to comply with all city and county ordinances and state laws relating to building 4Y r: r
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
�� .�va.rf'.� 'T4'.� �`j''�w. �`.. - ,. � -�. .. .. =k.�" w „•ri-..!'•' i ". ..�v - ., ,'�. ,} 4`7-.':+•'./.' •'�'�'�+;l-N-a i� .�..,��r=�,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® ' ' $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
FOR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
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,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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
M=CH.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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
/
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
///
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