14368 (RPL)e Z
4
�l P.O. BOX 1504
Building ®8-755 ; uobrook 'Lade78-495 CALLE TAMPICO
Address s LA OUINTA, CALIFORNIA 92253
Owner "Inco Homes
LDING: TYPE CONST.
No. 14368
mailing
Address 250 E. 'Rincon. Ave. #202
A.P. Number
City Zi Tel.
L4rona . CA 1719 (909) 736-0700 Legal Description
Con tr ctor Project Description 0901 - only
,nom Fi,y Pooh
Address ..
506 W. Mission Ave,
9��Condidot CA N992125 110* 377 -6557
State Lic. City
& Classif.. C",53 390179 Lic. #
Arcn., tngr.,
Designer
OCC: GRP.
Sq. Ft. ; No.. No. Dw.
Size Stories Units
New ❑ Add ❑. Alter ❑ Repair ❑ -Demolition ❑
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'Profeessions Code, and my license is ih/fullf6rrc9nn
effecI. 7� �a�'` , l �f x�- Z�� "'-1737
,SIGNATURE < ' fr I DATE
'OWNER -BUILDER DECLARATION E
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, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to the 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 ($500).
0.1, 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 of 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 o/ completion, the owner -builder, will have the burden
_ . or proving that he did not build or knprove for the purpose of sale.) ,
O 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 contractors) pcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner�fd"�'=
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
XCopy is filed with the city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation:
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ anyrpersdn in any manner so as to becom u6ject t'o the Workers' Compensation
Laws OJ'E311fOCrlla/� fes% �r�
Date ///y'f/ ('owner F : G�•`L?--... %t� r,
NOTICE TO APPLJCANT: -d;jaHer making this Certcate ol; Exemption you should became
subject to the Workers' Compensa8on provisions o/- the'Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. -AND '
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE -LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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.
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.
Signature of applicant Date
Mailing . Address
City, State, Zip
stimated Valuation $14000.00
00.00
BY:
I
PERMIT
AMOUNT
Plan Chk:.Dep.
Plan Chk. Bal.
99.45
Const:
153.00 .
Mech:
24.00
Electrical '-
45.00
Plumbing
27.00
S.M.I.
Grading
Driveway Enc.
Infrastructure
!I
Validation:
,
TOTAL
348.45
'REMARKS
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center' Line
Side. Set back from Property Line '
FINAL DATE
INSPECTOR
Issued by:
Date + P
Validated by:
!I
Validation:
NOV 2 9 Mill
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM a
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCKSTORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEOUIP.
-1+r
DRAINAGE PIPING
CARP. SO. FT.
TEMP. POLE
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN.
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FRAMING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING '
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
LATHING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
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 i inil
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH).
STORAGE TANK
FORMS
SEWER OR SEPTIC AN
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
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
FINAL INSP.
GRADING
cu. yd.
$ -plus-x$_=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
J
Fill,
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