12068 (SFD)J
P.O. BOX 1504 No. 1.2068
78-105 CALLE ESTADO
Address 54-090 Villa LA,,QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST.
A.P. Number
Legal Description
ProjectDescription
me -
OCC: GRP.
�� • �� �n�
A.
Cr f*V14 Calic
Mailing y
Address Same
City
QYl it%ci CA
Zip
42253
Tel. 564-1866
Contractor
Solar Distributors Inc.
W skel Ave.
City
Palm Springs, IM
Zip
42262
Tel.
32ff-2385
State Lia
City
& Classif. 480900 C-46
Lic. # 7 (
Sq. Ft.
Size 360
No. No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ 'Demolition ❑
Address
Tel.
City.
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I herebyy affirm that I anp licensed'under provisions of Chapter 9 (commencing with Section
Z000)•of;Division 3 of the Business and Professions Code, and my.license.is in full force and
f
SIGNATURE 1 DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city orcountywhich requires a
-permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file 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 Professions 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 five hundred dollars ($500).
❑ 1, 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 year or completion, the owner -builder will have the burden
' of proving that he did not build or improve for the purpose of sale.)
Estimated Valuation
9 t�
$3 t 000.44
PERMIT
AMOUNT
Plan Chk., Dep.
_
Plan Chk. Bal.
Const.
1,5• �V
Mech.
Electrical
Plumbing
4.50
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
S. M. I.
Grading
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
Worker's Compensation Insurance, or a certified copy thereof^(Sec. 300, Labor Code.)
Poli- o. Company J iXi r`(.r f
Copy is filed with the city. ❑ Certified copy is hereby furnished.
,
, `
TOTAL
19 . SID
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 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.
REMARKS
+Yi.f^7�8-raif1'�1)`�~Y7t1-.Sit
Date Owner
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
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 Street Setback from Center Line
Side Setback from Property Line
Lender's Name
FINAL DATE
INSPECTOR
Lender's 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.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-.
mentioned property for inspection purposes.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
2ND FL. SQ. FT.
STORAGE TANK
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. Q. FT.
REINF. STEEL
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.r2�
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
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 z PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING LONDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER Ql�iirPMC O GH 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
GRADING
cu. yd.
$ plus x$
= $
LUMBER GR.
FINAL INSP. -.,cYU
FRAMING / �� y 3
u,
FINAL INSP.r2�
ROOFING '8 3 L
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/( ( 7
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL _16 2 L
"ILATHING d ! L hJ
MESH
INSULATION/SOUND 6�
FINISH GRADING
FINAL INSPECTION �_
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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This Certificate issued pursuant to the'requirements.of Section. 306 of fhe •Building!
- � f .. :- - ,ti. ,�. ,Uniform
CodeLcertify ng°thlaf at the time, of issuance 'this structure wos ji compliance with`'thetivairious
-.�o ^J�.:r• :ri .�T,,.
>ordinances,of. the City"re' ulating"building,construction;or�'use. For the -,following
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J 12068
J"Single, Family`Dwelling, �=Bldg:^Permit
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;Use Classificotion� No.
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i 'Group' �,,'R3' * .Type}Construction w+=`%N , Fire Zone `Use ,Zone SR -
;Mr A .
P.:-Lenc-hII;e,�54�-• 0J 90'- Av,.enida Vilyla" '
Address,Owner.of Building•
'Qi'nt
p7
92253
t+
J. f, Y �. By; Connie •Dael, si
30,r` 19 9.4
Date f'March
C ' •: •` '
Building Official >; ,� � mss: ,,
t :t, • `. F + r POST, IN ACON9PIC0009' PLAC£ . • •a °' o ,o r ' ;
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