10527 (RPL)P.O. BOX 1504 ] No. 10527
Building 78-105 CALLE ESTADO
Address 45-365 Desert Eagle LA QUINTA, CALIFORNIA 92253
Owner
Ratulo C11232i@Y
Mailing BUILDING: TYPE CONST. OCC: GRP.
•
Address SEurl8.
A.P. Number
City Zip Tel.
La Qt'ainta 92253 Legal Description
Contractor Project Description Fool S-pa w/ 180 sf Patio
Address cover
P. 0. Box 835
City Zip Tel.:
Palm Desert 1 92260 568--4014
State Lic. City
& Classif. C53 397 252 Lic. # 529 Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer - New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City �Izip State Patio Cover - 2,358.00
Lic. #
�' ICENSED'CONTRkbTOR'S DECLARATION
I he affirm that I,am Iicens� undevprovislons of Chapter 9 (commencing with Section
7000) of Divviision 33rof,tthe/Btfssi6ess and,Professions Code, and my license is in full fore d
it'ffect>�.aC.. J✓ ";i4/1'i� �i'�r; �r."
2—
SIGNATURE d DATE
OWNER-BUILDER DECLAR WIGN--...•
I hereby affirm that I am exempt from the Co tor's License Law for the following Estimated Valuation 14,733.00
� 733 Q�
reason: (Sec. 7031.5,Buslness and Professions Cdde: Any city or county which requires a _ •
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also _
requires the applicant for such permit to file a 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. heis exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant l9rr a permit Plan Chk. Dep.
subjects the applicant to a.civil penalty of not more than five hundred dollars ($500). Plan Cihk• Balc y
❑ I, as owner of the property, or my employees with wages as their sole compensation, will . i"•
do the work, and thestructure is not Intended or offered for. sale. (Sec. 7044, Buisness and Const. 162.00
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees, Mech. 27.00
provided that' such improvements are not intended or offered for sale. If, however, the building
orimprovement is sold within one year of completion, the owner-builder will have the burden Electrical 45.00
of proving that he did not build or improve for the purpose of sale.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing24.00
struct lhe.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 S.M.I. - 1.50
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. 9. & P.C.•for this reason Grading
Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATIONb
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
j%Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 364.80
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 (,t3r 3 it i y 1'1 77n' A j
employ any person in any manner so as to become subject to the Workers' Compensation
CalifGi I,f iDate—
Laws of ornia.
NOTICE TO APPLICOANT.•r If, after making this Certificate of Exemption. you, should become ' ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from'Center Llne
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil code.) . Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly 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. 'Issued by: Date Permit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. Ff.
HEATING (FINAL)
OTHER APPJEQUIP.
WALL SQ. Fr.
GAS (FINAL)
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
Q
//� y� ✓✓✓
G�
_ S
0�
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
IT SVC
ffAMPERES
WATER CLOSET'
COMPRESSOR HP
LAVATORY
HEATING SYSTEM FORCED GRAVITY
ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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 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
FINAL INSP.
ROOFING
Q
//� y� ✓✓✓
G�
_ S
0�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION-
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL