10921 (ELEC)Addrdwcg 77-550 DURANCO
T4&t 4 4 Q%&
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
PALMERCABLE
Mailing
Address 41-725 COOK
City
Zip
Tel.
PALM DESERT
92260
1340-1312
Contractor
TAECRENS SERVICE ELEOCRIC
Address -
77811 CALL$ SINALOA
'City - .
Zip -
Tel.:
LA QUINTA
192253
568-4800
State Lic.
&Classif. C10-502256
City
Lic.# 1567
Arch., Engr.,.
Designer -
Address
Tel.
City .Izip ISt to
LICENSED COWRACTOWS DECLARATION -
I hereby affirm that I am If 9 - under provisions of Chapter 9 (commencing with Section
7000) of ivision 3 oflhe Businessand Pro(essbns Code,.and my license is In full force and
j
effect. r-' f- S --1 di de..
�'.f L- iL `moi
SIGNATURE 1 f r' DATE
01111NElF9U11DER DECLARATION .
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,liLsdrresa- and PFrdissalorra Code: My My or county which requires a
pem* ro construct, ase►, bnpnwe, d'ehnoisI,, or rsprb any strucbae, prior to its Issuance also
for such perml ft) go=1=944=1 Law. Ig I staternerd that he �r s c�UM 70000) of
Division 3 of the Briskiess and Profewbas ceft or that: he Is exampt thers(mm, and the basis
for the aArged exemppon. ' My vI 111 rh of Seegon 7031.5 by any awficant for a penruT
sutl)ecfs the spplbadlo a _ penaay of net more than five hundred loners ($500).
❑ I, as owner otthe property, or my employees with wages as their sole compensation; will
do the work, and the-shucture is not.intended or offered for sale. (Sec. 7044, SuLvress and
Rolessims Code: The Conb2cf rs License Lew does not eA* to an owner of property, who,
&A* or hhproves Menem and who does such work himself or through hfs own employees.
provided that shndr krpmvananta-are not Intended or offered for safe. 9, however: the bukft
or kriprovernerd Is sold WAN one year of onhh, 1. N h, the owner -builder. wX have the burden
of proving that he, did not build or kwove tar Me purpose of safe.)
O 1, as owner of the property, am exdusively contracting with licensed contractors. to con-
struct the project (Sec. 7044,, Business and Proresaluns Code:- The Contrectoi's License Law
dues not apply to an owner o►proPeiry'who Lx� Of Lnpnvea-thereon, and who contracts for
,.such pro/ g wIl/h a rzntrador(8) Beertaed pursuant to the Conbactork License Law.)
O I am exempt undersea R 11-P.Q for this reason
Date Owner
WORKERS COYPENSATION'DECLARATION
I hereby affirm that I have a certificate of consent to 'seli-insure, or a certificate of
Workees.Compensation Insurance, ora certified copy thereof. (Sec. 3900, Labor Code.)
7(��y
Camparry is filed with the Gty. ❑Certifiedcopy CE1171FK:ATE OF D�IIPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be conplal d fie pemd Is for one hundred dollars ($100) vahratbn
or less:)
1 certify that In the Performance of the work for which this permit is issued, 1 shall not
employ any Califarrlls. ppeerson in, any manner so as to become subject to the Workers' Compensation
Laws of
Datil [),roar
NOTICE Tt) APW1Ci1NT: If. .alter rtuIIS Mtr Certificate or ExenWt(w you should become
subject to the Nbrkara' Cornmaeori provlshorhs of the Labor Code. you must forthwith
comply wkh.such provtabne or cede pent abas 6e deemed revoked.
CONSTRUCTION U31WHO AGENCY
I hereby affirm that there is a construction lending agency for the performance of -the
work for which this permit is issued (Sec. 3087, Chd Cade.)
Lenders Name
Lenders Address
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.
trto npwith l state laws
relating to
and hereby of trdinances and his city to enterto
mentioned property for Inspection purposes.
Signature of applicant Date
Mailing Address
city, state, zip_
No. 10921
TYPE CONST. OCC: GRP.
Number
Legal Description
Project Description ELECTRIC PEDESTAL
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
51
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Driveway Enc.
Infrastructure
TOTAL
REMARKS
AMOUNT
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. PLUMBING FEES
1ST FL. SO. FT. ® 3
UNITS
SLAB GRADE
2ND FL SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. @MOBILEHOME
SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE '
URINAL
ESTIMATED CONSTRUCTION VALUATION S
GROUT
WATER PIPING
NOTE:. Not to be used as property tax valuation,FLOOR
FINAL INSP.
DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN.
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARK&
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 ® 114 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Ac
HOUSE SEWER
MESH
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 3 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.SI24,'
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. �o�
GRADING
cu. yd.
i -Plus -4-=$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
REMARK&
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION- �+
CERT. OCC.
FENCE FINAL
INSPECTOR'S' SIGNATU RESIINITIALS
GARDEN WALL FINAL