14879 (SATT)44
P.O. BOX 1504 -No. 14879
Building 78-495 CALLE TAMPICO
Address 48-626 Cz-11e Raperanaa LA OUINTA, CALIFORNIA 92253
Owner
Boer Sne� lenbe rc�cr & Associate -S Vit R3
BUILDING: TYPE CONST.• OCC: GRP.
Mailing" '
Address 41-86.5 Boardwalk #212 646-121-023
121-023
A.P. Number
City Zip Tel. y Lot. 43.' Tract .20052-4.
P,1 111,. € eSerts L:1 922313 (619)'777-7766 Legal Description
Contractor'SIM . Plan. ss
5�Same- _ Project Description
Address
ia�. gulara De. -LA Paz.
City Zip TO.:
State Lic. City
& Classif..H -'4.88234 Lic. # a858 Sq. Ft. No.: No. Dw.
Arch.,"Engr:,
Size 2�:. Stories - - Units
Designer Carlos .Elias d tasgineer ' New ❑ Add ❑ Alter ❑ Repair.❑ Demolition ❑
3 d a Charlesworth Dr • (g19) 328-7271
.City Zip State
C-athee-al_City CA 92234 ' Lic.•#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that l am licensed unde:provlsions of Chapl 9 (commencing with Section
000) ofyDi/Ojsio�n 3' f the Bus'in/e�ss an rofess/iCIFF , , a y license 's in full force and
effecI
. IC.f�i1Gi /%�IaL�J�4I��^
$1GNATURE -- DATE
OWNER -BUILDER DECLARATION Estimated Valuation . Q t $1
I hereby affirm that) am exempt from the Contractor's License Law for the following 19
1.915 a V0
reason: (Sec. 7031:5,13ustness and.Professions Code: Any•cfty.or county which requires a
psimif to construct, after, 6nprove, demolish, or repair."any structure, -prior -to its issuance also
requires the applicant for such permft-to file 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 the basis
_ for the alleged exemption. Any violation of Section 7031.5 by -'any applicant for a permit: Plan Chk: Dep: a�
subjects the applicant to a civil penalty of not more than five hundred dollars (8500). - , . C 3
I, as owner of the property, or my employees with wages as their sole compensation, will . Plan Chk. Bal. • • .
do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and ' COnSt' 7039 50
'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 throughhis 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. Electrical 342
of proving fhat.he did not build or hrprove for the purpose of sale.) •
52
01, as owner of the property, am exclusively contracting with licensed contractors to con- PlUmbing 138 • 00
strucl the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property r who builds or improves thereon, and who contracts for S,M.I: . . 11.99
such projects with'a contractors) (Icensed pursuant to the, Contractor's License Law.) -
❑ I am exempt under Sec B. 8 P.C. for this reason Grading 20.00
-
Driveway Enc. •.Q8
Date Owrter i ,' Infrastructure 642.73'.
Arts in -Public.- Places 49.! 79
WORKERS' COMPENSATION DECLARATION %
I hereby affirm that'l have a certificate of consent to self -insure, or a certificate, of
Worker's Compensation Insurance, or a certified. copy thereof. (Sec. 3800, Labor Code.)
Policy o- Company
Copy is filed with the city. .. O Certified copy is hereby furnished.
TOTAL 1 4.372.46
CERTIFICATE OF EXEMPTION FROMr REMARKS
WORKERS' COMPENSATION INSURANCE
(This sectbn need "not,be completed If the permit -is. for one hundred dollars ($100) valuation -
'br less.) - -
I certify that in the perfomnance of thp.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
Daie " Owner
NOTICE TO APPLCANT:.ff. after making this 'Certificate of Exemption. you .'should become .ZONE: _ BY: '
subject to -the Workers' Compensation 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 Pr Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL',AND Side StreetSetback-from t ine
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 Pro ine
' DAMAGES AS PROVIDED FOR IN SECTION 3706' OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. "
This is a building pemiit when properly filled out, signed and validated, -and is.subject to FINAL DATE I,NS TOf�
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 ^ �l�frTjlt
I agree to comply with all city and county ordinances and state laws relating to building' y ((
const. ctlon, 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 i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING; FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. SO. FT.
GAS (FINAL) TEMP. POLE
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
=$
FLOOR DRAIN
MECHANICAL FEES
FRAMING
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IKITCHEN 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 ® 11/4 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 I d ELECTRICAL HEATING & AIR COND. SOLAR
t R
SETBACK
GROUND PLUMB 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
�12- �J
� � /'j/�
J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAL
LATHING / I
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC. I
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL