14599 (BLCK)44
t P.O. BOX 1504 No. 14599
Building 78-550 Ave. La Fonda 78-495 CALLE TAMPICO
Address LA QUINTA, CALIFORNIA 92253
Owner Mike Ca sey
Mailing same
BUILDING: TYPE CONST. OCC: GRP.
Address
A.P. Number
City, Zip Tel.
�6 Qt iota, C, 92253 Legal Description
Contractor 200' cs£ 6' high garden wall.
owner/BuilderProject Description
Address 9 'All* xfib cg'atdck-% v.;Al I
City Zip Tel.:
State Lic. City
& Classif. Lic. # Sq. Ft. No. No. Ow.
Arch:, Engr., Size Stories • -- Units
Designer New ❑ Add'D Alter ❑ Repair ❑ Demolition ❑
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.
SIGNATURE - DATE -
OWNER -BUILDER DECLARATION Estimated V81UatlOn'$61000.00
t Alf �t
I hereby affirm that 1 am exempt from the Contractor's License Law for the following $6 1 00 .00
reason: (Sec. 7031.5, Business, and Professions Code:. Any city or county .which requires a
Permit to construct, after. Improve, demolish, or repair any structure, prior to -its issuance also I
.requires the applicant for.such permit to rile a• signedstatement 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 or 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 rive hundred dollars ($500).
p I, as owner of the property, or my employees with.wages as their sole compensation, will Plan Chk. Bal.
Vdo the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. ��
Professions. Code: The Contractor's. License Law does -not apply to an owner of property who. L)1•
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 knprove 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 andProfessions 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 contractors) pcensed pursuant to the Contractor's License Law.) .,
❑ I am exempt under Sec. B.4 P.C. for this r Grading
soa
1f R f . d Driveway Enc.
Date • `fowner }� 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 a certified copy thereof. (Sec. 3800• Labor Code.) - -
Policy No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished. -
TOTAL 81.00
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred", dollars ($100) valuation
or less.)
I certify t�sb
in the performance of thg.work for which this permit is issued, I shall not
employ any, ppn In any manor so as to"becom#ey'$ubject torihe Workers' Compensation.
LDawe ,(flif� �'
i�C Owner'
NOTICE TO APPLICANT: ft, after
makin g ,this 'CertNicate o! Exempthn you should become'.: ZONE: BY: '
subject to the Workers' Compensation provisions o! •the Labor Code, you�rriust forthwith.
comply
with
such provisionsorthis
permit
shallbedeemedrevoked. Minimum Setback Distances: '
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL;AND Side Street
.Setback from Center Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL- FINES UP TO ONE
.HUNDRED THOUSAND DOLLARS ($100.000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from Property Line -
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,,INTEREST, AND
ATTORNEY'S FEES.
This is a building permit uvhen properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
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.. Issued by: Date Per
I agree to comply with all city and county ordinances and state laws relating to building L ��
construction, and hereby authorize representatives -of this city to .enter the above•,
mentioned property for inspection purposes. Validated by: I
Signature of applicant Date -
Mailing Address Validation: I JAN ;
City, State, Zlp I"d
By hl
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. S0. FT.
YARD SPKLR SYSTEM
FOR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. S0. FT. ®'
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN,
S0. FT. ®
HEATING (FINAL) .
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
�3
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR -SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 I c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
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. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
�3
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 �S
CERT. OCC.
�FENCE'FINAL
INSPECTOR'S SIONATURESlINITIALS
GARDEN WALL FINAL