003619 (GRES)Building
Address
Owner
44
P.O. BOX 1504 No. 003619
78-105 CALLE ESTADO
53-777 Villa LA QUINTA, CALIFORNIA 92253
David Lavison
Address P. 0. BOX 1028
City Zip
. La. Quince : _ 92253 .
Contractor
.€wher/Builder
Address
BUILDING: TYPE CONST. OCC: -GRP.-
A.P. Number 774-1737025
Tel.
Legal Description
Project Description Catage fMordge area
-
' City . ..
.
Tip
Tel..
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
,reason: -(Sec. 7031. 5, Business and Professions Code: -Any. city or, county ;which 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
State Lic.
& Classif.
City
Lic. #
Sq. Ft. No. No. Dw.
Size's Stories Units
' Arch., Engr... ...
Designer ,
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Const.
_ .. ..
City
..
Zip
State
Lic. #
or Improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or•improve.for the purpose of sale.) -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions. Code, and my license is in full force and
effect.
or
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
,reason: -(Sec. 7031. 5, Business and Professions Code: -Any. city or, county ;which 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
Estimated Valuation.
.� PERMIT
.the provisions o/ the Contractor's License Law, Chapter -9 (commencing.- with Section 7000). of*
Divlsion.3'o/ the Business and Wofessions 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.
-
.Plan' Chk..Dep:.'
'subjects the applicant to a civil penalty o/ not more than.five hundred dollars ($500):'
• ❑•l, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
Const.
do the work, and the structure isnot intended or offered .for sale. (Sec. 7044, Bulsness and
. Professions Code: The Contractor's License Law does not apply to an owner of propertywho'
'a//
builds or improves thereon and who does .such work h' or through his 'own employees,
that such improvements are not intended or o/lered /or sale. ll; however, the building
Electrical'
or Improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or•improve.for the purpose of sale.) -
Plumbing
O 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,
doesnot apply to an owner of property who builds or improvesthereon, and who contracts for
- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 .I am exempt under Sec..B.. B: & P.C. for this reason
S.M.I. .
Grading
Driveway Enc.
Date'?-'` •Owner
Infrastructure
Side Setback from Property Line
WORKERS' COMPENSATION DECLARATION
' I hereby affirm that I have a'certificate' of consent to self-insuie, or'a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) .
FINAL DATE
Company ' - — •
'Policy No. •
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.
❑ Copy is.filed with the city. .❑ Certified copy is hereby furnished. .
TOTAL
by:
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS'
I
(This section need not be completed it the permit Is for one hundred dollars ($100) valuation
less •• -
18,331
0
AMOUNT
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
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you - should ' become
ZONE:
t r ♦ rc:
BY:1 V, ml {t f
subject to 'the Workers' Compensation provisions o/ 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 -
CONSTRUCTION LENDING AGENCY_
Side Street Setback from Center Line
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
Lender's 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.
I certify that I have read this application and state -that( the above information is correct.Issued
by:
Date Permit
agree to comply with allcityand county ordinances and state laws relating to building:
I
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
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING INS
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. 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 APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
X �F,4
41/�� IIIJJJ /�
QQrCG). V
r• /J /y
SQ.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
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 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.
FRAMING
FINAL INSP.
ROOFING
X �F,4
41/�� IIIJJJ /�
QQrCG). V
r• /J /y
REMARKS:
VENTILATION
FIRE ZONE ROOFING,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
4J •