15092 (SFD). 4.4
P.O. BOX 1504
Building 78-495 CALLE TAMPICO -
Address 47--785 Via Hite LA OUINTA, CALIFORNIA 92253
Owner il�e8 Ctx�nitie�
xu?.
Mailing . B
Address 1535 South OD" Street A.
City Zip Tel.
San'Bernardi ,• CA 924.08 (909) 381-6001 L
Contractor Pr
Same
Address . .
City .. .. Zip Tel.:
: TYPENo. 15092
UVN R3
ILDINGYPE CONST. OCC: GRP.
P. Number 617-790 '017
Le Description
Description Lot 17 Tract 26152 Phase
oject Description SFD Plan 2
Spinnaker Cove,• at Lake La Qui>nta
State Lic. City
& Classif.. Lic. # S Ft. No. No. Dw
' S `31.473 2120 4-
• -Arch.; Engr.,
Size 1950- - Stories. Units
DesignerPrarik (a6nza1.p-s a AssociatesNew ❑ Add ❑ Alter ❑ Repair ❑
r S East Chap'm;i x Ave. Tel {710532-.687 .
City Zip State
6rs1e,; ,CA, ' 92666 Lic. #
'` LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter.9 (commencing with Section
7000) of Division -3 of the Business and Professions Code, and my licen,ssree /its+in full force•and
effect. -`! ✓" ""^*5 a�/�Fr'
- _ r
SIGNATURE .•-'°" - f_..�••""' DATE I
OWNEWBUIL•DER DECLARATION
I hereby affirm that I am exempt'from the Contractor's License Law.for the following Estimated Valuation $117,469.00
reason: (Sec. 7031.5,Business' end. 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 Ole a signed statement that he is licensed pursuant to
) -
-PERMIT
the provisions of the Contractoor's, License Law, Chapter 9 (commencing with Section 7000) -of
Division 3 of the Business and Professions Cade, or that. he is exempt therefrom, and the basis
P for the alleged exemption. 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
-
Plan Chk-•Dep.
Plan Chk, Bal.
Const.
'
'Mech. i
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
Electrical
orImprovement is sold within one year of completion, the owner -builder will have the burden
ofproving that he did not build or Improve for the purpose of sale.)
Plumbing
❑ 1, 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
S•M•1. -
such projects with a contractors) Vicensed pursuant to the Contractor's License Law.) - -
' 10 1 am exempt under Sec. B- & P.C. for this reason
-
Grading
Driveway Enc.
Dale owner
Infrastructure
".----77
ArtA kn PubIi c Place
WORKERS' COMPENSATION DECLARATION
. I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance; ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. .Company
0 Copy is filed with the city. O Certified copy is hereby fumished. -
Z ••
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not. be completed -ff 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 becomesubjectto the Workers' Compensation
Laws of California
Dale Owner w
NOTICE TO APPLICANT: M, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the tabor Code, you must forthwith
complywith 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 ($100,000), 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 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.,
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives ,•of - this city fo enter the, above.
mentioned property for inspection purposes.,
Signature of applicant �+-"'r '��.� - Date Z
,Mailing Address-�-'
City, State, Zip "
Demolition ❑
AMOUNT
586.56
702.5(0
143.57
138.00
1.1.7.5
20_00
.00
2,643.04
41.67
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: g
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
f
2ND FL. SQ. FT. p
STORAGE TANK
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
REINF. STEEL
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
FINAL,INSP.
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
A
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WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® I% 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 .j/ 9S
GROUND PLUMBING �� 9 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE L��
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER` R S ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL,INSP.
FINAL INSP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
ROOFING �' /` / ->
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
r
LATHING 9V
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL