05225 (SFD)T4tyl 4 4 a"
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address •48-539 Amistad LA QUINTA, CALIFORNIA 92253
Abe & . Theltaa 3rosaman
Mailing
Address A! A vrea 214 A ."I
City Zip Tel.
Contractor
James Cashman, Sterling Corr,
Address
77-200 Minnesota
City Zip Tel.
& Classif. 195333 I Lic. #
Arch., Engr_,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
h aflnm at 1 am licensed under provisions of Chapter 9 (commencing with Section
7 of bivthat
3 of the Business and Professions Code, and my license is in full force and
effect. 1x1
. 9GNATr1nE �:GYP..rt',/._,lJfaY.`-a*- 6d�+".a'` ^a-�'/"p'✓r K "r.. l ` f DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reasons (Sec 7037-5,13rcvness and Professions Code: Any city or county which requires a
permit to cerstruct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he Is licensed pursuant to
the provisions of the Contractors License. Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Brrsiiress 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 Ove hundred dollars ($500).
❑' I, as owner of the property, or my employees with wages as their sole compensation, will
do the wort, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and
Pmfessions Code: The Contractors 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,
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.)
❑l 1, 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 mot apply to an owner of property who builds or improves thereon, and who contracts for
such projects with contractors) licensed pursuant to the Contractor's license Law.)
❑l I am exempt under SeG B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Wodtets Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polity Na Company
Q Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
f1ft section need not be completed if the permit is for one hundred dollars (S100) valuation
or less)
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: 8, after making this Certificate of Exemption you should become
subject to the lNbrkers' Compensation provisions of the Labor .Code, you must forthwith
comply with such Provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 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.)
Lenders Name
Lenders Address
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.
1 certify that I have read this application and state that the above information is correct.
agree to comply with all city and county ordinances and state laws relating to building
Conshtrction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 05225
BUILDING:• TYPE CONST. OCC: GRP.
A.P. Number _61 617-671-01 c
Legal Description
Project Description r11-- ILL, Lot 15
Sq. Ft. 1852 No. No. Dw.
Size - Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
C Qt rt t /t 9
PERMIT
AMOUNT
Plan Chk. Dep.
S250-00
Plan Chk. Bal.
S 1
Const.
4 2 A . DO
Mech.
19-00
Electrical
73i1
Plumbing
Q11 n
S.M.I.
Grading
Driveway Enc.
Infrastructure
1$3.150.36
TOTAL
REMARKS'
d
J1.
ZONE: BY:
Minimum Setback Distances:
Fiont Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
12/30/88
Issued by: Date Permit
Validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE 11309A
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. ®
WALL SO. FT. ®
WATER HEATER
DRINKING FOUNTAIN
FINAL INSP.
URINAL
SO. FT.
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
OOFINGr,
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ILAUNDRYTRAY
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
SO.FT.GAR ® VAc
HOUSE SEWER
FINISH GRADING
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
PLUMBING
UNDERGROUND UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 11309A
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCTWORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
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.
FR__ING Z-®
FINAL INSP.
OOFINGr,
n�
/
REMARKS
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND vt
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL
x? - 'Pat
OF
(fit
of
tutu
P
Mt II
utt in, an, ��ufeNb
t t ton;�
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building!
Code certifying)that at t -he' of issuance: this structure was in compliance with the various
ordinances of the City regulating building construction or' use: Foi the following:
48=539 Via Amistad
BUILDING ADDRESS'
single Family Dwelling 05225
Use Classification Bldg. Paimit No.
i Group R3 Type Construction Vn- Fire Zone Use Zone SR I
Abe and Thelma Grossmaii', 9010 -Corbin'kve.,"§te. 3 s!)
Owner of Building Address
City Northridge, CA 91324
By. - Richard Kirkland
Date.. • April 7, 1994
Building Official
y. It -. 4 MT IN A 0Wd*CU0U3 PLAtt