14958 (SIGN)- P.O. BOX 1504
No. 141958
Building78-495 CALLE TAMPICO
Address 0-855 Washington Ste. R LA QUINTA, CALIFORNIA 92253
Owner baa Qui tta Bike Shop,
Mailing ` BUILDING: TYPE CONST. OCC: GRP.
Address Same
A.P. Number
City Zip Tel.
,airinta .CYC 9225 773-9622 Legal Description
Contractor Project Description ( I) Wall Sign
Signs & Services
Address
10980 Boatman Ave.
_CiMty ,~, Zip Tet : ,
entoCA 90680 t714) 761-8200 s
State Lic. City z
& Classif... C-45- 439828 Lic: # 3543 Sq. Ft. No. N No. Dw.
Arch., Engr:,
Size Stories - Units
Designer D i II t' 11
Address
City lZip
• LICENSED COI
I hereby affirm that I am licensed_und,
Tel.
State
Lic. #
9 (commencing withl$ection
ny license is in full force/nd
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7.031.5,Business ,and Professions Code:- Any city or county . which requires a . ,.
permit to construct, eller, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant. to .
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and'Prolessions Code, or that. he is exempt therefrom,- and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit .
subjects the applicant to a civil penalty of not more than Ove hundred dollars ($500). • .
❑ 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
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,
. provided that such Improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one yearr of completion, the owner -builder will have the burden.
of proving that he did not build or Improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
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.
such projects with a contractors) (icensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Date Owner
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.). -
PoliEy o. .Company
CrCopy is filed with the city, ❑.Certified copy is hereby furnished.
New ❑ Add ❑ Alter ❑
Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I. , -
Grading
Driveway Enc.
Infrastructure "
TOTAL
Repair ❑
emo on
AMOUNT
35.4;
CERTIFICATE OF EXEMPTION FROM
• WORKERS' COMPENSATION INSURANCE '
REMARKS
' (This section need -not be completed If the permit is for one hundred. dollars ($100) -valuation
'orless.) '
I certify that.in the performance of thg work for which this permit is issued, I shall not
" 1 -
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT. d, after making - this Certificate of Exemption you - should become ,
ZONE: -
BY: '
subjectto the Workers' .Compensation provisions of the Labor Code, you. must forthwith
comply with such provisions or this permit shall be deemed revoked.
-
Minimum Setback Distances: -
Front Setback from Center )_-'n
Rear Setback from. Rear ne
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
Side Street Setback f Titer •ne
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 fro fly LI
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND:
ATTORNEY'S FEES.
This is a building permit when properly filled out, signed and validated, and is'subject to
FINAL DATE
L
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 Pe tit
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-.
%
90
mentioned property for inspection purposes.
Validated by:
i
Signature of applicant Date
Mailing Address
Validation,.
City, State, Zip
7
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIWU FEES
1ST FL. SO. FT. @ $
2ND FL. SO. FT.
POR. SO. FT. @
GAR. SO. FT. @
CAR P. SO. FT.
WALL S0. FT. ®'
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN,
URINAL
WATER PIPING
NOTE: Not to be used as properly tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR . SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
INAL INSP. —
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
-SMIFEE 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
GRADING
cu. yd.
.$ —Plus—x$—=$
LUMBER GR.
INAL INSP. —
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 SIGNATURES/INITIALS
GARDEN WALL FINAL