06396 (RPL)Building
Orlrfrccc 44-125 WP -2 Court
Glen AUxander
Mailing
Address
City Zip
Las Quinta.. 92253
Contractor
Unique FIs by Caine
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
345-7855
74-818 Qelie Way 01
CityTel
Zip
Palm Desert 92263 346-6335....
State Lic. City -
& Classif. 520432 Lic. # -x.366 _
Arch., Engr.,
Address I Tel.
CityIZip I State
Lic. #
j UCENSED CONTRACTOR'S DECLARATION
I heieby affirm that 1 am licensed under pr''ov-of of -Chapter 9 (commencing with'§ection
7(100) of Division 3 of the Business and Professions Code, and my. Iicerfs6 is full f forr�e`and
effect C
SGNATURE_.-' --4--W -". y—r.wi.I'?':�`i!' .•�- —av ./ ./' DATE
OWNER -BUILDER DECLARATION /
I hereby affirm that 1 am exempt from theContractor's License Law for the following
reason: (Sec. 7031.5,ambess and Professions Code: Any city or county which requires a
Permit to construct, alter, inprove, demolish, or repair any structure, prior to its issuance also
requires the alep6cad for such pemd to fie a signed statement that he is licensed pursuant to
the provisions of the Contractors 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 exemptim. Any vioWion of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a aril penalty of rat more than five hundred dollars ($500).
❑ 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
Professions Code: The Contractors License Law does not apply to an owner of property who
builds or improves therem and who does such work himself or through his own employees,
provided that such rrpmvanents are not intended or offered for sale. If, however, the building
or mprovemeni is said wNA. one year of completion, the owner -builder will have the burden
of proving that he did not bund or improve for the purpose of sale.)
❑ I, as owner of the properly, am exclusively contracting with licensed contractors to con-
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
• such projects with a coetracter(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Se(' --B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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
❑ Copy is filed with the city- ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
1 certify that in the performance of thg 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: f, after maldrg this Certificate of Exemption you should become
subject to the Workers' Canpensatim Provisions of the Labor Code, you must forthwith
comply with such provisios 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, Cin? Code.)
Lenders Name
Lender's Address
This is abuilding permit when property filled out, signed and validated, and is subject to
expiration if work thereuruier 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'
BUILDING: TYPE CONST
A.P. Number
Legal Description
Project Description
No.
OCC: GRP.
Cactus Flag
Pool At spa
REMARKS
1v
ZONE:
BY:
Minimum Setback Distances:
Sq. Ft. 260
Size
No. No. Dw.
Stories v -Units
New ❑ Add.❑
Alter ❑ Repair ❑ Demolition ❑
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
-9/26/89
Issued by:
Date Permit
Estimated Valuation
$9,500
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal
76.05
Const.
117.00
Mech.
24.00
Electrical+'
30.00
Plumbing
27.00
S.M.I.
.70
Grading
Driveway Enc.
Infrastructure
TOTAL_
REMARKS
1v
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
-9/26/89
Issued by:
Date Permit
Validated by:
Validation:
a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB,Pf?t ;� BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT. @
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
MOBILEHOME SVC. -
BAR SINK
POR. SO. FT. ®
AS (ROUGH)? C�� ER LOOP
GAS(ROUGH)ad
Yl
GAR. SO_ FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CAR P. S0. FT. ®
GROUT
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
4
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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 J
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 ® 11/4 c
SEWAGE DISPOSAL
INSULATIONISOUND
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
FINAL INSPECTION
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,Pf?t ;� BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
AS (ROUGH)? C�� ER LOOP
GAS(ROUGH)ad
Yl
HEATING (FINAL)
OTHER APPIEOUIP.
REIN F. 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
FINAL INSP.
ROOFING
L
i Q v V96•'i�
'0�o^
i
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL