The URL can be used to link to this page

14320 (SIGN)a 4 x' P.O. BOX 1504 Building 50J929 Th ash3.ngton St. 78-495 CALLE TAMPICO. Address LA QUINTA, CALIFORNIA 92253 Owner La Uinta Village Mailing Address '79 6 W. -Ninth St, . City Zip Sari Pedro 50733 Contractor Signs a . Services idd a C3s'1:tman cityStanton, CA` zip 90580 State Lic. - & Classif.. G--45: 439.€ 28 Arch.; Engr., Designer Address _..(734) 76i1-=820 City Lic. # Tel No.14320. BUILDING: TYPE CONST: OCC: GRP. A.P. Number Legal Description " Project Description (2) Signs. Sq. Ft. No. No. Dw. Size - -Stories Units New ❑ Add ❑ Alter ❑. Repair ❑, -Demolition O Date Owner WORKERS' COMPENSATION DECLARATION ` I hereby affirm hat I have a certificate of consent to self -insure, or a certificate of Worker's Compe ton Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company Ot6 py is filed with the city.. ❑ Certified copy is hereby furnished... CERTIFICATE OF EXEMPTION FROM - WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars. ($100) valuation or less.) I certify that in the performance of the 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 InfLrastrucure I I TOTAL REMARKS ' NOTICE TO APPLICANT: N, after making . this Certificate of Exemption you - should • become ZONE:' — City . Zip State Front Setback from. Center Line Lic. # /t1. LICENSED CONTRACTOR'S.DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND ' reby affirm that 6m licenapunder provisions of Chapter 9 (commencing with Section' 7 ) of Division of'the BusinProfessions Code, Side Street Setback from Center Line andess nd and my license is in full force and ,�3 .. SIGNATURE-- r ,1. .,_.-._ DATE .. .. _ _ ' WNER-BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following 0/� 0 Estimated Valuation ,,11 800.00 -+@'q F}� •V - 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 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 t ie.basis.- for the Any Section 7031.5 'any -applicant 'for ' Plan. ChK Dep. - _ alleged exemption. violation of by a permit - subjects the applicantto a civil penalty of not more than rive hundred dollars (8500).. . , 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 - or improvement is sold within one year of completion; the, owner -builder will have the burden EIBCtrIC3I' - - of proving that he did not build orrnprove for the purpose of sale.) .. ,. l l ❑ 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 - such projects with's contractor(s) (!tensed pursuant to,the Contractor's License Law.) - S.M.I: • . Signature of apphcan� Mailing.Address —Ji— % IeKF✓ Grading ❑ I am exempt under Sec B. 8 P.C. for.this reason Driveway Enc. Date Owner WORKERS' COMPENSATION DECLARATION ` I hereby affirm hat I have a certificate of consent to self -insure, or a certificate of Worker's Compe ton Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company Ot6 py is filed with the city.. ❑ Certified copy is hereby furnished... CERTIFICATE OF EXEMPTION FROM - WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars. ($100) valuation or less.) I certify that in the performance of the 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 InfLrastrucure I I TOTAL REMARKS ' NOTICE TO APPLICANT: N, after making . this Certificate of Exemption you - should • become ZONE:' BY: subject to the Workers' Compensatlon 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 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. - - ' This is a building permit when properly filled.out,osigndd and validated, and is subject to FINAL DATE INSPECTOR expiration it work thereunder is suspended for 180 days. ' t I certify that I have read this application and state'that°the above information is correct::. Issued by- Date 1 Permi I agree to comply with all cityd'county ordinances and state laws relating. to building construction, and hereby/authonze?representatives of. this city to' enter the , above-. it mentioned groperty�fordr�ispectionpuryoses:T t� d Q Validated by: t ,. l l Signature of apphcan� Mailing.Address —Ji— % IeKF✓ Validation:qq City, State,_ Zi P Y " (,e d ��+,. `J,-•�� ` ... . ,. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CARP. SO. FT. WALL SO. 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 property 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11A c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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 ROCKSTORAGE 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. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTIO l CERT. OCC. FFN(:F FINAI SIGNATUREWINITIALS GARDEN WALL FINAL