05621 (RPL)4
P.O. BOX 1504 No. 05621
Building 79775 VESTMD BS LA Q
Address UINTA, CALIFORNIA 92253
Owner
Mailing
Nestern Builders BUILDING: TYPE CONST. OCC. GRP.
Address 617_111-001
A.P. Number
City Zip Tel.
Legal Description -
Contractor Sparkle Plenty Fools Project Description Fool to SFA
Address 69481 Bion Way
CityZip Tel.
Cathedral City 92234 619/328-9260
State Lic. 53 522$76 City
& Classif. Lic. # 299-- Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
.1- Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I sin licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and mylicense is in full force and
effect-
SIGNATURE
ffectSIGNATURE • r-'~ DATE
OWNER -BUILDER DECLARATION Estimated Valuation a
I hereby affirm that I am exempt from the Contractor's License Law for the following Y11 ��rQ�
reason: (Sec. 7031.5,Busness and Professions Code: Any city or county which requires a
permit to construct, alter, kgprove, demolish, or repair any structure, prior to its issuance also
requires the appicant 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. he is exempt therefrom, and the basis
for the alleged exemption. Any violatiion of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a ciW penally of not more than rove hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 81.93
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and r1S126.00
Professions Code: The Contractor's License Law does not apply to an owner of property who Const.t
buikls or rnprovas thereon and who does such work himself or through his own employees, Mech. 4.00
provided that such rrprovements are not intended or offered for sale. If, however, the building
or improvement is solo within one year of completion, the owner -builder will have the burden Electrical 45.00
of proving that he did riot build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 27.,00
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 knproves thereon, and who contracts for S.M.I.
such projects wBh a contractors) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec B. ti 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
Workers Compensation Insurance, or a certified copy thereof}{Sec. 3800, Labor Code.)
Policy No Company f— X it
❑ Copy is filed with the city. ❑ Certified copy is hereby fur ished—
TOTA L .,.-
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation i���1•• i ,..' r.% 3 ' -1 h.^� r • ,L
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: ff, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions orthispermit shall bedeemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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
Lenders Name
Lenders 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. 4/10/89
89
1 certity 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
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
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
AS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
BOND BEAM
WATER SYSTEM
URINAL
SQ FT ®
=$
LUMBER GR.
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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
lKITCHEN 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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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 �f /('
AS (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 SIGNATURESIINITIALS
GARDEN WALL FINAL