Loading...
002166 (SFD)vz w� �Qut�fw P.O. BOX 1504 No. • �� 2166. 'Building g i 78-105 CALLE ESTADO �` Address LA QUINTA, CALIFORNIA 92253 Owner BUILDING: -TYPE CONST: OCC..GRP. r •' Mailing Address 75-005 0MMtrV C 3 M. A.P. Number _ City ZipTel. Palm ,. .gO .56$,,,2$28•. Legal Description Contractor "Project Description ' . NVII& Address .... .. ......... `.! ,Sam City . ,• . .... .Zip .. Tela . ngrxa State Lic. City & Classif. 288130 Lie. # . 328 Sq. Ft. No. No. Dw. ? „ « Size Stories- - Units - --Arch.; Engr.. Designer : New ❑X Add ❑ Alter ❑.: Repair ❑'-' Demolition ❑ Address Tel. Mm powx for Sewer Uf statim City Zip State Lie. # A 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'forceiand"" effect. - � g.__.:l > .r•e..: f^ rr . f„ , �'i': v F • .Y , err v f . ' SIGNATURE DATE - OWNEWBUILDER DECLARATION Estimated Valuation I hereby affirm that I 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. permit. to construct, alter, improve, demolish, or repair any. structure, prior to its issuance -also • -t-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 Piofessions Code, or. that. he is' exempt therefrom, and the basis for the Any Section -7031.5-by, 'any for Plan Dep. - alleged exemption. violation of applicant a permit subjects the applicant to'a civil penalty of not more'thani've hundred dollars ($500). ' .Chi(. Plan Chk. Bal; - ' .l'7 I,_as.ownerof 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 COr1St, r . 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 C q� 500 . 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 • 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 Lam exempt. under Sec. - B. R P.C: for this reason Driveway Enc. Date • owner Infrastructure WORKERS' COMPENSATION DECLARATION ' I hereby affirm that'I have a certificate of consent to selVinsure;'or a certificate of ` Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) - Policy No. Company O Copy is filed with the city... O Certified copy is hereby furnished. ' TOTAL . UU CERTIFICATE OF EXEMPTION FROMREMARKS ' WORKERS' COMPENSATION INSURANCE > .- . (This section need not be completed if the permit is for onehundred,dollars ($100) valuation - or less.) .. .. ... . _ .. ... _ 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, alter making this Certificate of Exemption you should become ZONE:- - BY. ' subject to' the Workers' Compensation provisions of'-the'Labor Code,- jou`must lorlhwith -MinimumSettiack 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:ffOm'.Center.Llne 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 fromProperty Line , Lenders Name Lender's Address "signed FINAL DATE ' INSPECTOR' •' - ' ThisAs a building permit when properly filled out, and validated, and is subject to ,' expiration if work thereunder is suspended for 180 days. y 3 1 .1 certify that I have read this application and state that. the above information is correct.- ' "I Issued by:'.- Date ' Permit. - agree to'comply with all city and county'ordinances-and slate 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 `y -+' ��i''. 6 Date . Mailing Address Validation: City, State, Zip r/ A4b90 3 •11 35,G0 Sl HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ®, MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APP.IEQUIP. DRINKING FOUNTAIN SQ 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM - 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. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 3/ac HOUSE SEWER LATHING 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 FANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. 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. FRAMING FINAL INSP. ROOFING - REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL