9867 (ELEC)PERMIT TAKEN 0UtRAFTEA �W
LIGHT INSTALLED 4
t
Building
Address 78-930 LA FONDA
Owner
FRANK C. DEMARBIB%
Mailing
Address SAME
City Zip
LA QtINTA,CA 192253
JUAREZ ELECTRIC
P.O. BOX 1504 (_ No.
78-105 CALLE ESTADO((
LA QUINTA, CALIFORNIA 92253 C�
BUILDING: TYPE CONST.LIGRT OCC: GRP.
Number
Tel.
Legal Description
Address
52-245 NELSON
City
Zip
Tela
COACHELLA,CA
192234
389-3411
State Lic.
City
& Classif. 302 580
Lic. #
Arch., Engr.,
Designer
Address
I Tel.
CityI Zip I State I
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
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,8usness and Professions Code: Any city or county which requires a
permit to construct, after, inprove. demolish, or repair any structure, prior to As issuance also
requires the applicant for such panni to fie a signed statement that hes licensed pursuant to
the provisions of the Contractor's License taw, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Cade, or Drat. he is exempt therefrom, and the basis
for the alleged exemption. Any vilobtion of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Yas owner of the property, or my employees with wages as their sole compensation, will
the work, and the structure is not intended or offered for sale. (Sec. 7044, Buesness and
Professions Code: The Contractors License Law does not apply to an owner of property who
builds or improves thereon and who Wes such work himself or through his own -,employees,
provided that such inprovements are not intended or offered for sale. 8, however, the, btnidig
or Improvement Is sold within one year of completion, the owner-buider will have the Lnui'rden
of proving that he did no build or irprove for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of properly who bolds orrnproves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.) \
❑ 1 am exempt under Sec— -----___j3. & P.C. for this reason
CC��
Date��"��`7� Owner J
WORKED' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished_
CERTIFICATE OF EXEMPTION FROM
WORKED' COMPENSATION INSURANCE
(This section need not be conplaled B the pemd is for one hundred do#= (11100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, 1 shall not
employ anyperson in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: ff. after making Ors certificate of Exemption you shady become
subject to the Workers' Conpersafim provisions of the Labor Code, you mat forthwith
comply with such provisions or Ors permit shat 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, ClviCode.)
Lender's Name
Lender's Address
This is a building permit when property 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
urposesSignature of applicant Date
Mailing Address
City, State, Zip
Project Description HALIGLN LIGHT FOR BOCHIA
BALL COURT. LIGHT TO BE FULLY SHIELDED
PER L.Q.M.C.
9.210
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
$15.00
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
�. yri,�.• V Vti - R n + ^c .!
REMARKS
1(1 �` 0W34T `i _Tl E aL t _1i. 00
ZONE: BY:
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:
0
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT, ®
CAR P. SO. FT.
WALL SO. FT. ®
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
I ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM. FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POL
KITCHEN SINK
ABSORPTION SYSTEM, B.TM.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPE RM
LAVATORY
r
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 ® 34c
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
IL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEEPLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL H/NG & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
L A.C. UNIT
COLL, AREA
TSLAB 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. POL
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION- �0
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL