003045 (PLBG)P.O. BOX 1504 No; 003045
Buildinga 78-105 CALLE ESTADO
Address 52-04'0 �€vouida� Vallejo LA QUINTA, CALIFORNIA 92253
Owner
Paul & Jaace Stetz
Mailing
BUILDING: TYPE CONST: OCC: GRP:
Address .52,4MO ,x' 12 ®''neia
A.P. Number
913'223-302
City .Zip
Tel.
• to .nix t-9
.92253-
56'4-3497
Legal Description
Project Description
pliz*hfap % ,n1tX_k—tr1.c_a 1 fin cPA_xAaraa-
_
Contractor
QFfdet'l$oUE et'
Address
` City .Zip
..
Tel.'.
State Lic.
City
& Classif.. •
Lic. #
Sq. Ft: •
No... No. Dw.
Size "
Stories Units
• _
Arch:, Engr:;'
• Designer
New OC Add ❑ Alter ❑ . Repair ❑ ' - Demolition 0 -
Address
Tel.
City
Zip
State
Lic. #.
LICENSED CONTRACTOR'S DECLARATION 1,
I hereby affirm that lam licensed under provisions of Chapter 9 (commencing with Section'
7000) of Division 3 of the Business and Professions Code, and my license is infull force and
' . effect. ..
SIGNATURE DATE
' OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec, 7031..5,Business and,.Professlons 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
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 orthrough his own employees,
provided that` such Improvements are not Intended or ;offered for. sale: If, however;. the building
Estimated Valuation.
-
PERMIT:;
-
-
.a• AMOUNT
.•r -
Plan Chk.. Dep..
- - -
-
Plan Chk. Bal..
,
COf1St'" '
-
Mech.
.
Electrical
-
.
or improvement is sold. within one year of completion, the owner -builder will have the .burden..
of proving that he did not build or improve for the purpose of sale.), -'
PlUmbing'
❑,I, as:'owner of the property, am exclusively contracting with. Iicensed contractors to con-
struct dhe-project. (Sec. 7044, 'Business and Professions.Code: -The Contractor's License Law
does not apply to"an owner or property who builds or improves, thereon, and who contracts for
such projects with a,contractor(s) licensed pursuant to the Contractor's' License Law.) ..
0 1 am exempt under Sec., B. & P.C. for -this reason
_
S.M.I. -
•' - '
Grading
-
Driveway Enc.
Date ;.ft'>'' ` ? owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
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
_ ❑ Copy is, filed with the city.- ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE. .
REMARKS
(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 Owher
NOTICE TO APPLICANT: If, after making this Certificate or Exemption you should become
subject to the Workers' Compensation provisions 'of the Labor Code, you must' forthwith
comply with such provisions or this permit shall be deemed revoked.
- ZONE:
Minimum Setback Distances: ' - ,
Front Setback from. Center Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line '
Ihereby 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
FINAL DATE
Issued by:
+
Validated, by:
INSPECTOR
Date 4/10187PerfTlit
x• -
' 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.
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
Validation:
6.7729
4 .10:. 26.00- (L
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. Q. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
GAS (ROUGH)
DRINKING FOUNTAIN
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
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.
SQ. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER*
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 GOND. 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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATJRESIINITIALS.
GARDEN WALL FINAL