9494 (PAT)(( • ��� ,
S
414
P.O. BOX 1504 No. 9494
Building 44-405 E. Sundcs in Crest rzx 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Mrs. Joanna Olson
Mailing
BUILDING: TYPE CONST. OCC: GRP.
Address 44-405 E. Sundown Crest A.P. Number
City Zip Tel.
La Quinta 92253 Legal Description
Contractor Project Description
Rago Coags yrlaction
Address Patio Cover
13m-285 Cactus Drive
City - Zip Tel.:
DHS 92240 329-0157
State Lic. City
& Classif. 8 370055 Lic. # 1677 sq. Ft. 290 No. No. Dw.
' Arch., Engr.,
Size - Stories Units
Designer New ❑ Add ❑- Alter ❑ Repair ❑ Demolitiori_O
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
llfhereby 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.
SIGNATURE ' d T DATE
'OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following �'(� V n
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or cowry which the,
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 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 civil penalty of not more than five hundred dollars.(5500). -
p I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 40.95
do the work, and, the structure is -not intended or offered for sale. (Sec. 7044..Duisness and Const. �.� o ��
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 Improve 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.I. - .40
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.).
Grading
0 I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date 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 acertified copy thereof. (Sec. 3800, Labor Code.) -
Policy No. Company
❑ Copy is filed with the city.. , O Certified copy is. hereby furnished..
TOTAL .04 • !
CERTIFICATE OF EXEMPTION FROM '
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dotiars ($100) valuation
or less:) -
I certify that in the performance of thg work for which'this permit is -issued, 1 shall not
employ any person in any manner so as* to become subject to the Workers' Compensation
Laws of California. s
Date i:l. ,ri>r Owner �/ �i'r'r.
NOTICE •TO'APP.LICANIbtiei making this Certificate of Exemption you should became
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
Ihereby 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 if 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 Date
Mailing Address
City, State, Zip
REMARKS
rkLitS� Cd'a i 4'r d � 1'Y t�,'d...'E i_:(a fi ✓� � ..
ZONE: BY:-
'Minimum
Y:'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 Permit'
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
A.C. UNIT
2ND FL SO. FT.
SLAB GRADE
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
ROUGH WIRING.
DRAINAGE PIPING
WALL SO. FT.
FOUND. REINF.
DRINKING FOUNTAIN.
SO FT ®
METER LOOP
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REINF. STEW/GAS
WATER PIPING
NOTE: Not to be used as property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
GROUT
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
BOND BEAM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
LUMBER GR.
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 ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR.® 114c
HOUSE SEWER
SPARK ARRESTOR
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.
REINF. STEW/GAS
(FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$
LUMBER GR.
FINAL INSP.
rrr���
FRAMING 73� ��[�
FINAL INSP.
ROOFING
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION 3a
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
-PR oPo Set>71
C (7 vC
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