14578 (ELEC)4
P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 45-45401 Desert Pox Drive LA QUINTA, CALIFORNIA 92253
Owner
Century Homes .
Mailing
Address 1.535 South "DO St. Suite 200
City Zip Tel , .
San .Bernardi.n , CA 924081(909)38.1-0041
Contractor
Power Pius
Address _ ...
2720 B. Regal Park Dr.
Wahiem, CIA' 2'p 2'806 TIe.1`00) 863-2525
BUILDING: TYPE CONST.—
No. 14578
OCC. GRP.:
A.P. Number
Legal Description
Project Description 140- Amp Temp Power Pole
�t
State Lic.
City
& Classif.. C--10. 523596
Lic. #
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
-
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I here b affirm thaw am licensed undelt provisions of Chapter 9 (commencing with Section
i 7000) of�wisio/ry oI the BB iinLess/aKd Professions Code, wand my license is iin'full force and
SIGNATURE I../ f DATE
�A
OWNER -BUILDER DECLARATION
Estimated Valuation
�C�a +�.
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
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 8 (commencing with Section 7000) of
'
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the Any Section 7031.5 by Any for
Plan Chk. Dep..
-
alleged exemption. violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
❑ 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..
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'
'
provided that such improvements are not Intended or offered for sale. If, however, the building
1 r >n
or improvement is sold within one year of completion, the owner -builder will have. the burden
Electrical
^�` 7,J
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 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.
such projects with a contractors) Qcensed pursuant to the Contractor's License Law.) -
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner
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 d� Company
'
19'Copy is filed with the city. 11 Certified copy is hereby furnished.
A _ �
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred dollars ($100) valuation
11 YY �
. .(This
less.)
I certify that in the performance of thg work for which this permit is issued, I shall not\.
�)
employ any pperson in any manner so as to become subject to the Workers'. Compensation
r iy
f
Laws of California.
Date Owner
r>v
NOTICE TO APPLICANT. ff, after making this Certificate of Exemption you should become
ZONE:
BY: \
sub)ect to the Workers' Compensation provisions of the Labor Code. .you. must forthwith
Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Minimum
Front Setback from Center. Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL. 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.
'
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. PLUMBINU FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. I SO. FT. ®
FINAL INSP.
I
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$
=$
URINAL
SQ. FT. ®
FRAMING
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
REMARKS:
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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
INSULATION/SOUND
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/e c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
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
WATER SYSTEM
FINAL INSP. ?j�
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING
FINAL INSP.
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 SIONATURESIINITIALS
GARDEN WALL FINAL