14638 (SFD)V.
P.O. BOX 1504
No . ' �' '
Building 78-495 CALLE TAMPICO "
146
Address 79-210 - Raga Court LA OUINTA, CALIFORNIA 92253
Owner hent tri Homes Conwr=itiez
Mailin
Address' .1-5A..�t`C3Uth m0a . StXeet a :ltd... 200
City Zip ]Tel.
Say iar narclino C 9�' : $ .. 3 3 �-6001
Contractor..
Address
City Zip Tel.'
State Lic..: 4,73 City '2120
&.Classif.. ' Lic. #
- Arch Engr.,
�Lis�-�c'��I)i �.�`lA,�.�.�it:' Fa ,�>3^a43C4.
• .: • .
�BsFassero A,ranue rfl�jI43$9 6066
i i�L1CS3 i�E'}, 411r : 9.25. 65 Lief#
-.LICENSED CONTRACTOR;S DECLARATION -
-
BUILDING: JYPE CONST. .t OCC: GRP.
A.P. Number
Legal Description Lot. 36 Tract 26188 Fess 1
Project Description ° ' ' Plan 3. -
.,Lel Rey at- Lia. menta Worte
Sq. Ft.
-Size
New ❑'
No'
4 ". -stories
Add ❑ ' Alter ❑ "
No. Dw.
Units .
Repair ❑
AMOUNT,
7a✓v
0, 00
�oV6J .�•". �.
5.20-
9'o 00 `.
Date1 Owner
Infrastructure 990.
SIGNATURE - DATE
-'
OWNWUILDERDECLARATION
Estimated Valuation
1 hereby affirm that I am exempf
t rom the Contractors License Law for the. following
-• reason:, (Sec.. 7031.5,Busfnass".,and' Professions .Code:.: Any., city, Or. county. which requires a
- permit -to construct, alter, -,Improve; -demolish, or -repair -any structure,•pdor to its•.fssuance also,!
- -
'.requires the applicant.for'such permit to file a slgned statement that he is licensed pursuant to
:. PERMIT'
the.provisions ohthe Canbactor's License Law, Chapter 9 .(commencing: with Section 7000) of
•.
-:Division 3.of the Business and Professkins Code; or thatf6e.fs'exempt therefrom; and.the basis.
Plan Chk..Dep.
for. the.alleged.exemption., Any- viofatkm of Section .7031.5, by Jany • applicant .for. a -permit
subjects the applicant to a civil penalty of not more than rive hundred dollars, -.(5500): '.
Plan Chk.
;. ❑ I, as owner.of the, properly; or my. employees with wages as their sole compensation, will
Bal.
do the work,•and the structure is not intended or offered.for sale: (Sac. ,7044, Buisness and
Const.
Professions Code: The. Contractor's License'Law does notapply to an owner of property who
HUNDRED THOUSAND DOLLARS ($100,000), IN'ADDITION TO -THE COST. OF COMPENSATION,.,:
DAMAGES AS, PROVIDED FOR. IN SECTION.3706 OF THE LABOR CODE, INTEREST, AND .
. builds or Improves: thereon andwho doss''such work himself or through his..own employees,
Meeh._'
.� provided. that. siich improvemaats:•are not. intended or offered for safe.,#, -however, the building".,,.
'
• or improvement Js sold within one, year or completion, the owner-60der will have the burden •
Electrical
:..of proving that he didnot bunld.or Improve for the purpose of. sale.)
_
O' 1, as. owner of the property; am exclusively contracting: with licensed contractors.to con-
Plumbing '-
- struct the project.(Sec. 7044,.', Business and:Prolessions 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
O I am.exempt,under Sec B. & P.C.ffor this reason
i
Drivewav Enc.
No. Dw.
Units .
Repair ❑
AMOUNT,
7a✓v
0, 00
�oV6J .�•". �.
5.20-
9'o 00 `.
Date1 Owner
Infrastructure 990.
WORKERS' COMPENSATION: DECLARATION
' I herepy affirm that I have a certificate of. corisent to self -Insure, ora'certificate of
' ' Worker�Eompensation Insurance; or a certified copy thereof.. (Sec. 3800; Labor Code:)
`Polj✓No: Company.
-
- O Copy is -filed with the city. .O Certified copy is hereby. furnished. •
TOTAL 3i21.+8"
CERTIFICATE OF EXEMPTION FROM'
WORKERS' COMPENSATION INSURANCE'-
REMARKS
-
(This section need not be completed -If the-permil Is for one hundred -dollars ($100).yaluation
-:.. 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 av to become subject to the:Workers'. Compensation" `
Laws of California
" "Date Owner.
• . , NOTICE TO APPLICANT: d, ager making-thisCertificate of Exemption' you' should 'become.
- subject to the Workers' Coirrpensa8on provisMns or ahe Labor Code, you must forthwith-
. . comply with such provisions or this permit shall be deemed revoked.- _
- ZONE: BY: -
".Minimum Setback 'Distances:
_
Front Setback from'Center.Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION' COVERAGE IS UNLAWFUL, AND
SHALL'SUB.IECT AN EMPLOYER TO CRIMINAL PENALTIES' AND -CIVIL, FINES UP. TO ONE
Side. Street Setback from'Center Line
HUNDRED THOUSAND DOLLARS ($100,000), IN'ADDITION TO -THE COST. OF COMPENSATION,.,:
DAMAGES AS, PROVIDED FOR. IN SECTION.3706 OF THE LABOR CODE, INTEREST, AND .
Side Setback from Pro rty Line .
.ATTORNEY'S FEES.-..' _ 4
This is a building permit when propi fly'filled out, signed and'validated, and is subject to
expiration it work thereunder.is suspended for 160 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:
.. ..
FINAL DATE INSP R
Q
Issued by: Date Per t
:. •.
/►
Val Validated by:
Signature of applicant Date
. Mailing Address +
Validation: a 199
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST 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. S0. FT.
SEWER OR SEF
DRAINAGE PIPING
WALL SO. FT. ®'
DUCT WORK .
DRINKING FOUNTAIN.
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
HEATING (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
TEMP. POLE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
WATER SYSTEM
FINAL INSP.
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 Vi c
SEWAGE DISPOSAL
FIRE ZONE ROOFING
SO.FT.GAR ® 3/ac
HOUSE SEWER
FIREPLACE
'
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE ; PL.C!I
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE � PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBI
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS'
SEWER OR SEF
ROUGH WIRING'
DUCT WORK .
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
1
METER`LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL 11 SP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
ROOFING
r
9 /
6
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
z
..
A ,"WALL
MESH
����^++++
INSULATION/SOUND 7 /
FINISH GRADING 'L
' FINAL INSPECTION v / vD
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL