14475 (BLCK)i o ,
^ o
TA
t_.
P.O. BOX 1504 No. 14475
Building 78-495 CALLE TAMPICO
Address 51-040 Ave* Valle ja LA OUINTA, CALIFORNIA 92253
Owner Esetui.el Caranel
Mailing , BUILDING: TYPE -CONST: OCC: GRP. -
Add ress
RP.Address P.O. Pox 1238
A.P. Number
City Zip Tel.
La-Quinta, eA . 9.2253. 4519) 564-4604 Legal Description "
Contractor' ,'s Project Description 10 Of 61: h1cjh block wall
Cormiel Cdhgitraction 1
Address ,
P.B. Box -1238
icit � itlta, CA zip 92253 T(619) 564-4604
State Lic. :B 634981* City 2261
& Classif:. Lic. # Sq. Ft. No: No. Dw.
Size • Stories Units
Arch., Engr.;
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition
Address Tel.
CityZip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700 c) 01` Division 3 of the Business and Professions Code, and my license is in full force ald
A.
SIGNATU E' DATE '
OWNER•BUILDERDECLARATION. Estimated Valuation Artrt ft
I hereby affirm that I am exempt from, the Contractors License Law for the following ,'�V V . 4a
reason: (Sec. 7031.5,Business. and Professions Code: Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance 'also I -
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 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 rove hundred dollars ($500).
❑ .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.. 54B 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, 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 purpose of sale.).
❑ 1, 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 contractors) (!tensed pursuant to the Contractor's License Law.) -
Grading
O 1 am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date Owner
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 Company
Copy Is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE'.
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
"'or less.)
I 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- ll, after making this Certificate of Exemption you should become ,. ZONE: BY: -
subject to the Workers' Compensation provisions or the Labor Code; you must forthwith -
complywithsuchprovsionsor this permit shaflbedeemed revoked. - Minimum. Setback Distances: - -
Front Setback froWRe"
in
Rear Setback from..LinSide Street Setban
Side Setback f 6m Prop Line
FINAL DATE SPECTOR192.
Issued by: Date Per
Ly -
Validated by:
Validation: I
Infrastructure
e+ a n
TOTAL
REMARKS
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 ($100,010), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 37.06 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 1 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 4o enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIJ — FEES,
1ST FL. SO. FT. ® $
UNITS
'
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GAS (FINAL)
TEMP. POLE
WALL SO. FT.
DRINKING FOUNTAIN
SQ. FT. ®
WATER HEATER
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
GRADING
CU. yd.
plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
!/
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
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 ® 1'A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE JELECT.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 APPJEOUIP.
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL