Loading...
11000 (MISC)f `'•. P.O. BOX 1504 No. 11000 &1 Building 705 CALLE ESTADO Address ���� � i�ejQ LAQUINTA,CALIFORNIA 92253. ' Owner Mrs. Slausen Mailing BUILDING: TYPE CONST: " OCC: GRP.' - Address saarn€?. A.P. Number City Zip Tel. I,a Quinta 92253 564-'-4077 Legal Description Contractor. Project Description .Steffen Plumbing Address _.. Gas Lineie install wall P. ®. BOX 6112 heater City Zip Tel.: Indo 92202 345-4353 State Lic. City & Classif. C36 565175 Lic. # I I Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units - Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zi� f/ State x- Lic. # �% I ENSEDyCOf� R7►CTOR'S DECLARATION I hereby affi that I a licensgAn er provisions of Chapter 9 (commencing with Section 7000) of Divis'on 3 of.the-Business�, d`Professions Code, and my license is in full force and effect.... - e.. 1f91\ OWNER -BUILDER DECLARATION Electrical - Estimated Valuation I hereby affirm that I am exempt from the Contractors License Law for the following . reason: (Sec. 7031.5,Susiness and Professions Code:. Any city or county. which requires a . ' ' struct the project. (Sec. 7044, Business -and Professions Code: The Contractor's License Law. Rear Setback, from Rear Prop. Line permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that hes licensed pursuant to • PERMIT 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 bas's • 0 I am exempt under Sec. B. 8 P.C. for this reason for the alleged exemption. • Any violation of Section 7031.5 ,by 'any- applicant for a pemu plan Chk. De p. subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. ❑ I, as owner of the property, or my employees with wages as:their sole compensation, will Validation: do the work, and the.structure is not intended or offered for sale. (Sec.' 7044, Buisness and Const. Code: The Contractor's License Law does not appy to an- owner of property who builds..or improves thereon and who does such work himself or through his own employees. M' ch. provided that such• improvements are not intended or offered for safe. h, however, the building 1-,050,00 orimprovement Is sold within one year. of completion, the owner -builder wi0.have'the burden Electrical - - of proving that he did not build or improve for the purpose of sale.) - ., Distances: ❑ I, as owner of the property, am exclusively contracting with licensed contractors to cow Plumbing ' struct the project. (Sec. 7044, Business -and Professions Code: The Contractor's License Law. Rear Setback, from Rear Prop. Line 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.) - Side Setback from Property Line Grading • 0 I am exempt under Sec. B. 8 P.C. for this reason Issued by: 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. I nsu rance, or a.certified copy thereof. (Sec. 3800, Labor Code.) . Policy No. Company 1!kopy is filed with the city. O Certified copy is hereby fumished: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE, (This section need not be completed if the permit is for one hundred dollars (5100) vahration 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: If, . after making this Certificate of Exemption you should become subject to' the Workers' Compensation provisions of the Labor Code,, you must forthwim comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a.constructioh lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code:) Lender's Name Lender's Address 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. ' 1 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 Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 15.00 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback, from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date - Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® GAS (ROUGH) Z U DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. 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.COOL 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, TEMIPERM 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% 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 TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) Z U ETER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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 SIGNATURES/INITIALS GARDEN WALL FINAL