14808 (PLBG)P.O. BOX 1504
Building 78-495 CALLE TAMPICO .
Address 78416¢ AVe. La Fonda LA QUINTA, CALIFORNIA 92253
Owner Annie Fischer
Address Sade '
City Zip
.La Q=.pinta, CA- 95253
Dateland Construction
-. Address
50-305 Hwy 111
City - • ZipTel.:
Cdachella, C 95236
State Lic.
& Classif.. C4,2- 396698
Arch:, Engr., -
Designer
Address
City
No. 14808
BUILDING:, TYPE CONST. OCC_ GRP.-
A.P. Number
Legal Description
Project Description Install a 0.1 (below inletl
expansion seepage pit -
Lic. # 31 Sq. Ft. No.
Size . • - Sto
Tel.
Zip State
Lic: #
LICENSED. CONTRACTOR'S.DECLARATION
tha 1 alicensed, under provisions of Chapter g (coi
3 0 tm tte By$iness and,Professions Code, and mv.lic
ii Mg with Se t'i
I qCg
is in full force 8and
tr #"^EW
OWNER -BUILDER DECLARATION '
I hereby affirm that I am exempt from the. Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a'
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition❑
permit to construct, alter. Improve, demolish, ,or repair any, structure, prior to its issuance -also
requires the applicant for such permit to tile 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 Section 7031.5 by 'any for
Plan Chk. Dep:
'
of applicant a permit
subjects the applicant to a civil penalty or not more than fivehundred dollars ($500).
Plan Chk. Bal.
O I, 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. (Sec. 7044, Buisness and
Const.
Code: The Contractor's License Law does not apply to an owner of property who
builds or irnpmves 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
30 * pp
struct the project. (Sec. 7044, Business and •Professions Code: The Contractor's License Law
does not apply'toan,owner of property who builds or improves thereon, and who contracts for
S,M.I, -
such projects with a contractor(s) pcensed pursuant to the Contractor's License Law.)
Grading
O I am exempt under Sec B. 8 P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby'r 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 . o. -Company
10�bopy is filed with the city, ❑ Certified copy is.hereby furnished.
TOTAL
30.00
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 that in the performance of the 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: N, after making this Certificate of Exemption you should become '
• • ZONE:
BY:
subject to the Workers' 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 Li
Rear.Setback from Rear Pr e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
Side Street Setback fro. r 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 Pr Line
DAMAGES AS PROVIDED FOR. IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEYS FEES.
This is a building permit when.properly filled out, signed and validated, and is subject to
FINAL DATE
IN CTOR
expiration it work thereunder is suspended for 180 days.
%f Perm
I certify that I have read this application and state that the above information is correct..
Issued by:. -
Date
I agree to comply with all city and county ordinances and state laws -relating, to building -
777
yyy ^
construction, and hereby authorize representatives -of this city. to enter the above-..
(. S/
mentioned property for inspection purposes.
Validated
Validated by:
t
Signature of applicant Date
Mailing Address
City, State, Zip
F.. i _ ty,• 1 .Sr .r� �,m ge, b2'. - ; y 4 - . .. =i. ..+
:..r - , g• _'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
`FINAL INSP. -
GARBAGE DISPOSAL
FURNACE UNIT- WALL FLOOR SUSPENDED
LAUNDRY TRAY
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ec
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE '.PPL.CK.FEE
r
CONST. FEE I ELECT..FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. r 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 APPJEQUIP.
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. -
FRAMING
j
FINAL IN S'
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
Ar -.._-.. ;..._. __ zc e..,_:._.