003738 (BLCK)P.O. BOX 1504 No. 00738
Building a"" G� . 78-105 CALLE ESTADO
Address VallejoLA QUINTA, CALIFORNIA 92253 .
-Owner
Herat Homes Ltd _
MailingBUILDING: TYPE CONST: OCC: GRP.• .
Address 7220 Trade Sti-eet S ? ite 100
A.P. Number -
Legal Description
Project Description
774 -123 -012 -
Retc�].1�i%1a '�r73ll .`�0X 21 ArO
City
Ste' M.ieqt3 -
Zip
9212.
Tel.
69-34444
Contractor6
Address. . _ ....
Sam
Minimum Setback
Distances:
City
Zip
Tela
Rear Setback from Rear Prop. Line
State Lic.
& Classif..,�
City
Lic. # �9
Sq. Ft.
Size
No. No. Dw.
Stories Units
Arch., Engr.; :. _.
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Validation:
City
Zip
State
Lic.•#
LICENSED, CONTRACTOR'S DECLARATION: -
I hereby affirm hat I am lice sed,under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of,thegBuslriess and Professions Code, and my license is in full force and
effect
...
.. .. _
SIGNATUREI• ' Pf' - .4-, .f` .{r ;" 'v-. i —,F / DATE
OWNER -BUILDER DECLARATION '
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiness and Professions Code: Any'cily 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 piovisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
' Division 3 of the Business. and Professions Code, or'thaf. 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 ($500).'
. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improvas thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, .however,, the building
or improvement is sold within one 'year of completion, the owner -builder will, have the burden
of proving that he did not build or improve for the purpose of sale.)
D I, as owner of the.property, am exclusively contracting with licensed contractors to con-
struct the project; (Sec. -7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for -
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I. am exempt under Sec. - B. & P.C. for this reason
EStlmdted Valuation
C
19s
•
.. -PERMIT
AMOUNT
r.:
Plan Chk: Dep.
_
..Plan Chk. Bal.
-
_ COrt$t.
s •�
Mech..
.
"
Electrical
-
Plumbing
S.W.. -
s 5
Grading
.
Driveway Enc.
Date owner
Infrastructure
t
WORKERS' COMPENSATION DECLARATION
' I hereby affirm that I have a certificate of consent to self-insure,'or.6 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. ❑ Certified copy is hereby.furnished. .
TOTAL
CERTIFICATE OF EXEMPTION FROM
_ WORKERS' COM PENSATIO N 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 thg 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 forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.) '.
Lender's Name
Lender's Address
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 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 Qate
Mailing.Address
City, State, Zip
HARD COPY
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 3/2.2./-88 Permit
Validated by -
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SD. FT.
FOR. SO. FT. ®
GAR. SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SO. 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 APPJEOUIP.
R INF. STEEL /
AS (FINAL)
TEMP. POLE
GROUT
oo,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