001799 (BLCK)44
P.O. BOX 1504 N o . 001799
Building 53--666 A►�y p -J0
Address
Owner Ed Weeks
Mailing
Address
City Izip
Contractor
AUO
.Address.. ..
Tel.
fO-105 CALLS COADO
LA!QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST..
p OCC: GRP...
A.P. Number
Legal Descriptionv` / I
Project Description
43-874 S3Am.
City
.
Tel.
M� w
Tip...
922%
State Lia
City
Lie. #+��t
45 chain 13mc
& Classif.74
Sq. Ft: No. No. Dw.
Arch.,Engr
Size +� Stories Units
Designer
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition C
Address
Tel.
City
Zip
State
_ .
Lic. #
LI¢ENSED CONTRACTOR'S DECLARATION
I hereby affirm that,lzam licensed under provisions of Chapter 9 (commencing with Section
7000) of Div"isiont3 of the�Bussine s and Professions Code; annd-my license is in full force and
..effect. i .r-. ..
SIGNATURE If DATE
- • • , -
f - .. OWNER -BUILDER DECLARATION
."
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License. Law for the following
�•�•
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
. permit to construct, altei, 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
-
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 Any Section 7031.5 by' for
Chk: Dep..- - - '
alleged exemption. violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).-
,plan -
Plan Chk. Bal.
❑ I; 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.aad
Const' 20.00
- 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 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 improye 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.1. -
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.). -
-
Grading
q Lam exempt under Sec. B: & P.C: for this reason
Driveway Enc.
Dale 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
.O Copy is filed with the city. , ❑ Certified copy is hereby.furnished. '
TOTAL 20.00
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) 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.
Oate " 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,. you must forthwith
comply with such provisions or this permit shall be deemed revoked. -
.Minimum Setback Distances: '
- '
Front Setback from Center Line
Rear Setback from.Rea.r Prop. Line
CONSTRUCTION LENDING AGENCY.
Side Street Setback from Cienter.Llne
I 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.)
Slde•Setback from Property Line -
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
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.
Issued by Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city Yo enter the above--
mentioned property for inspection purposes. `•
Signature of applicant +' x "+x .F� . t .� _� ir' Date f ��
Validated by:
Mailing Address
Validation:
City, State, Zip
A 3 3 2 0 11 15 20.00 Ck
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
FOR. SQ. FT. ®
GAR. SQ, FT. ®
CARP. SQ. FT.
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
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 APP./EQUIP.
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
�d
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.,