07091 (BLCK)44
P.O. BOX 1504 No. 07091.
Building 4105 CALLE ESTADb1-'Zr'
Address 52-905 Vel"co _LA QUINTA, CALIFORNIA 92253
Owner
Harlon White
Mailing BUILDING:�TYPE CONST... .7. OCC: GRP..
Address 1.q_ fir: A.P. Number 773-325-022
City Zip Tel;
Escondido 92025 564-2480,. Legal Description
,,,Contractor Project Description 29 X 1.501"Retaining'vaU
GarY BWM Aggeat
Address.
City 2
State Lic.
& Classif.
Sq. Ft.
Size• I
No.
,Stories
No. Dw.
Units
, ngr.,
Arch. r-
Designer
New 0, Add 0 Alter 0 Repair 0 -Demolition 0
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 -
,
M.of Division 3 of the, Business and Professions Code, and my license is in full force and
• effect:
.
SIGNATURE DATE
OWNER -BUILDER DECLARATION'
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
7031.5.Business Code:
reason: (Sec. and Professions Any city or county which requires a -
permit to construct, after, imProve• demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Me 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 civilpenally of rat more than live hundred daflars.($500).
Plan Chk. Bal.
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
Const. $45.00
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 mitendied or offered for safe. 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 orkriprove for the purpose of sale.)
0 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 buzilds or improves thereon, and who contracts for
S.M.I.
such projects with a contractorfs) fice?sed pursuant to the Contractor's License Law.)
P14
Grading
• 0 1 am exempt under Sec. .'&'PC. for this reason
Driveway Enc.
Date 2 - Owner
Infrastructure
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
0 Copy is filed with the city. El Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS 6,21"WIV "It" 5-44"
WORKERS' COMPENSATION INSURANCE
11142
(chis section need not be completed If the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thp work for which this permit is issued, Vshall not
employ any person in any manner so as to become subject to the Workers' compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ff, after making Uds Certificate of Exemption you should become
ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
Comply with Such Provisions or thts Permit Shag be deemed revoked
minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line--
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued: (Sec. 3097, CW Code.)
Side Setback from Property Line
Lender's • Name
Lenders Address
FINAL.DATE
This is a buildingpermit when properly filled out, signed and validated, and is subject to'
-INSPECTOR
expiration it work thereunder is suspended for 180 clays.
2/14190
I certify that I have read this application and state that the above information is correct.
Issued.by: Date -Permit
I agree to.comply with all city and county ordinances and siate. 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 Date
Mailing Address
Validation:
City,. State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL SQ. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SQ. FT.
GRADING
cu. yd.
plus x$
=$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
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Arw
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
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% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Yic
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 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 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
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESANITIALS
GARDEN WALL FINAL