003205 (BLCK)A/
Building
Address 54-900 Avenida
Owner
Coachella Vell
Mailing, . -
Address 719 V4114A**A n
City Zip
. VA -
Contractor
Stmfr Conxtx=
..Address
Zip
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No'
003205
BUILDING- TYPE CONST. -OCC.GRP..-
A.P. Number 774-302-411fW-47
Tel.
Legal Description
Project Description 1^*04"#�Mff Vlol I
Tel.'
T'sivss
1 92262
- .=01020_..
State Lic.
City
& Classif. . 387934
Lic. # 751.1-
Sq. Ft.
No. No. Dw.
•Size.
Stories Units
Arch.; Engr:, -
Designer
New 0 Add 0
Alter El Repair 0 . -Demolition'D
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
7000) of Division 3 of the Business,and Professions Code, and my license is in full force and
effect.
op 40,
SIGNATURE" LATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
7031.5,Bus,iness. Any,city
reason: (Sec. and Professions Code: 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 file a signed statement that he is -,licensed pursuant to
PERMIT
AMOUNT
the provisions of the Contractor's,Ucense Law, Chapter,9 (commencing With Section 7000) of
Divisiqn, Vol the Business and Professions Code, or that. he is exempt therefroin,,and the basis
for the Any 'of Section -by 'any 1for
Plan Chk. bep.
alleged exemption. violation .7031.5 applicant a permit
subjects the applicant to'a civil penalty of not more than'five hundred dollars ($500).
Plan'Chk. Bal.:'
Cr 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. (Se0 7044, Buisness.and
Const
q0.
Professions Code: The Contractor's License Law does not apply to an owner of propply who
S38
builds or'improves theie6n 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'Mech..
or improvement is sold within one year of completion, the owner -builder will have the burcie
r!'
Electrical'
of proving that he did not build or improve for the purpose of sale.) , , . . . .
0 1, as owner of the property, am exclusively contracting, with. I icensed 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.I.
such projects with a contractor(s) licensed pursuant -to the Contractor's License Law.) -
.
Grading
0.1 am exempt. under Sec. B. & P.C., for this reason
Driveway Eric.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
Thereby affirm that'l have a certificate of consent to selfAnsure, or"a certificate of
• Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)'
Policy No. company
4Q�Copy is filed with the city. 0 Certified copy is hereby furnishedi
TOTAL
A 7t 4A Ctvig,% n.7"^838.50
CERTIFICATE OF EXEMPTION FROM
REMARKS
iv lllf4h 1. YOTAL i!
WORKERS' COMPENSATION 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 thp work for which this permit is issued, I shall not
employ any person iwany manner -so as to become* subject to the Workers' Compensation
Laws of California.
Date --L----L_Owner
NOTICE TO APPLICANT: If, after making this Certificate of, Exemption you should become
ZONE:—
BY:
subject to the: Workgrs' 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 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 isIssued. (Sec. 3097, Civil Code.) •—Side
Setback from Property Line
Lender's Nam
Lender's Address
FINAL DATE*
This is a building permit when properly filled out, signed and validated, and is:subject to
—INSPECTOR
expiration it work thereunder is suspended for 180 days.
I certify that I have this
read application and state that,the above information is correct.
I to
-,Issued by-
Date Permit
agree 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.
Validated by:
Signature of applicant Date
Mailing Address.
Validation:
City, State, Zip
_Y1...
HARD COP
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
A.C. UNIT
COLL. AREA
SLAB GRADE
IST FL. SO. FT. ® $
UNITS
HEATING (ROUGH)
2ND FL. SO. FT. p
FORMS
YARD SPKLR SYSTEM .
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
OTHER APPJEOUIP.
DRAINAGE PIPING
WALL S0. FT.
TEMP. POLE
DRINKING FOUNTAIN
SO FT ®
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
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 ® 11/4 c
SEWAGE DISPOSAL
LATHING
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
INSULATIONISOUND
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
ROUND 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 77 (6
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 SIGNATURESIINITIALS,
GARDEN WALL FINAL