15355 (SFD)P.O. BOX 1504 No. 15355
Building 78-495 CALLE TAMPICO
Address 51-325 r$veinda Diaz LA QUINTA, CALIFORNIA 92253
Owner
Santa Fe Homes
Mailing' BUILDING: TYPE CONST. V1q OCC: GRP. SIZ
Address P.O. Box 450773-043-022
A.P. Number
i . City Zip Tel.
La Quinta 92253 564-1866 Legal Description Lot 8 Block 49
ContractorLendel Ventures, Inc. Project Description single Family Dwelling
Address
P.O. Box 450
City Zip Tel.:
La Qui nta 92253 554--71866
State Lic. City
& Classif. B-=6305,35 Lic. # 859 Sq. Ft. 2001 No. No. Dw.
Size Stories Units
Arch., Engr:,
Designer New 9 Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Address Tel. Permit includes 210 if of 6' gardenwall,
City Zip State and 75 if ,sof' 4' gardenwal.l, and roar patio
Lic. #
cover. Pmol and additional cork permits to
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section be obtained separately.
7000) t.of Division 3 of the Business and Professions Code, and my license is In full force and
'
effec
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I herebyaffirm that I am exempt from the Contractor's License Law for the following Estimated Valuation 2 » 0
P 9 p16,t3�$.�i�}
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior to Its issuance also • i
requires the applicant for such permit to rile 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. he Is exempt therefrom, and the basis plan Chk. De$250.00
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit p
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chl(. Bal.
•
0 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. F34.
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. S • 00
i provided that such Improvements are not Intended or offered for sale. If, however, the building Q
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical $ .Z,. 8 `%
of proving that he did not build or improve for the purpose of sale.)
p I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing $144.00
struct the project. (Sec. 7044, Business and .Professions Code: The Contractor's License Law 4p�
does not apply to an owner of property who builds or Improves thereon, and who contracts for S.M.I. W -• 1
such projects with a conlractor(s) licensed pursuant to the Contractor's License Law.)
Grading $ 20.00
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc. .00
Date Owner Infrastructure • 0
ER in F=11 Places 65. 19 --
WORKERS' COMPENSATION DECLARATION recise,lCar. 25..00
1 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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL $4445.49- *4
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed N the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT.- ti, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($ID0,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. &
This is abuilding 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.
1 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
REMARKS
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. 0
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. 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.
WALL SO. FT.
WATER SYSTEM
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE,TEMIPERM
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/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Ac
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 APP.IEOUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL