10549 (PLBG)Building 52-°201 Villa
Address
Owner
hues@
Mailing
Address P. 0. BOX y 3 2
City Zip Tel
P.O. BOX 1504
78.105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Contractor
Econo Sewe 'r
Address
P. 0. Box 192
City ZIP Tel.: '
Palm Deser'ie 92261 1 3$6--2793
No. 10549
BUILDING: TYPE'CONST. OCC: GRP.-
A.P. Number
Legal Description
Project Description
. Sewer Hook Ufa
& Classlf. 480961 I Lic. # 342 I Sq. Ft. No. No. Dw.
A. -k C__. Size Storles Units
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed u der provisions of Chapter 9 (commencing with Section
7000)of Division 3 of the S felriess ajfd Professlons Code, and my license Is In full force and
effect.. // -. ,fk� . f 121 5;1- .
SIGNATURE .G- i"-': + d DATE
OWNER(BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bustness and Professions Code: Any city or county which requires e
permit • to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuance also
requires the applicant for such penult to file a signed statement that he Is licensed pursuant to
the provisions of the Contractor's License Lew, 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 o/ not more than five hundred dollars ($600). .. .
O. 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, Bulsness 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 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 Lew
does not apply to en_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.)
0 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, br a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Lebor.Code.)
Polley No. .Company
EI Copy Is filed with the city. O 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 anypparson 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
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit Is Issued. (Sec. 3097, Civil Code.)
Lender's Name
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 -of this city to enter the -above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep:
Plan Chk. Bal.
Const.
Meth.
Electrical
Plumbing 30.00,
S.M,I.
Grading
Driveway Enc.
Infrastructure
$ 713
2i" t
TOTAL - 30'."00""
...._
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ 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.
LAUNDRYTRAY
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.
SQ. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
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
SEWER9114� R
OUGH 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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
Vis'` - �+ry • r +
.1 •:t. .♦ rdr '•)� - „�:,' va'.'•�••i• .n. s• 7,1'/ ff :.j' :^� ,`�•i,. .L,-, s•
., .v,..,: L't' .• �•..'. .i tai \''. ... rtl: .',\/. Y ytt ! .�{ t
T yt,
!� COACHELLA VALLEY WATER DISTRICT,
CASH RECEIPT DETAIL 35 6 44,
f. Received From: VA &'( \ e.f L ' N Ue' Ss c Date' 3o Q
i- Address: gns3� G car }-,`
Account No. f pQ In `> \ 1 1S .y. D Lot(s) q' Tract r (1
Service Address 5:.2 t� 1 \i 1 ;r✓ G.A. Code
! , ❑ Meter(s) - s•
..❑, Service(s) .d
❑ Backflow(s) ' `" �•
" ❑ House Lateral(s) * '
❑ DetectorCheck(s)" t
❑ Meter Surcharge
i g4anitation Capacity Chaige
i
❑ W.S.B.F.C.
❑ Temporary Construction Meter 4
' l ❑. Turn on Charge,
f . ❑ Uncollected Account - Name
f '
❑ Inspection Fee - Tract - y �:
Y
Fee -
O Plan Check Fees .Water I Sewer -
Tract -
' ❑ Bond Payment - A.D. - Bond
t Assmt.
❑ Customer Deposit
❑ Other ,
s ,
' TOTAL
Remarks: `
❑COPY to: y
Cash k' `� Water Service LU
Check /Lv
Money. ' Cashier
Order CVWO-438(11189)