13244 (PAT)I
T a 0
it!t 4 Qub&
P.O. BOX 1504
Building
Arlriracc 78-645 Rorbes Circle LA QUINTA, CALIFORNIA 92253
Owner
Mr. & Mrs. 'William Parris
Mailing
Address Same
City Zip Tel.
La Quints, CA 92253
Contractor
Patrick'3. Buggy
48-687 Schafer Place
-Valm Desert, :9 92250 '772-3989
State Lic. City
& Classif. ' B1 642953 Lic. # 256'9
Arch., Engr.,
Designer
Address
CityI Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division�'of- he,.Buslness and Professions Code, and my license`is in I tilt and
effect. ��`�/" � f
SIGNATURE ",✓ `: rs ..� "�-�/ / �. -) DATE
`y OWNER -BUILDER DECLARATION f
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 rile 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).
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 gale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does nov pply 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 intendedsor 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.)
0 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,.o% property who builds or improves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
1 am exempt under Sec. B. t;. P.C. for this reason
I'll
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate,o( consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a ceftified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Comps y
❑ Copy is filed with theocity ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ 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 gin any manner so as to,Eecom 'subject to the Workers' Compensation
Laws of Cali ordia. --^r��
Date %/ t J1 -Owner
NOTICE TO�'APPLICANT: 1/, after making''this Certificate of Exemption you should become
sub%ect to the Workers' Compensation1provisions o/!the Labor Code, you must forthwith
corriply with such provisions or this permit shall be deemed revoked.
"t
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.)
Lender's Name ,,,••"
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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.
el
Signature of applicant Date
Mailing Address
City, State, Zip
BUILDING: TYPE CONST
No.
OCC: GRP.-
A.P. Number
Legal Description
Project Description Patio Cover
13244
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation ,�yy nn
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
46.80
Const.
72.00
Mech.
Electrical
Plumbing
S.M.1.
.50
Grading.
Driveway Enc.
Infrastructure
TOTAL
1 l ii
REMARKS
ZONE: BY: ' t t 11 11
Minimum Setback Distances:
Front Setback from Lter Line l
Rear Setback from r Prop. Line jy
Side Street Setbacfvilrl,?r -11U
Side Setback,from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit _w
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT.
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
FOUND. REINF.
GAS (ROUGH)
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APPJEQUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO. FT. ®
I
WALL SO. FT. ®
GROUT
DRINKING FOUNTAIN
SERVICE
URINAL
SO. FT. ®
BOND BEAM
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
FRAMING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
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.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
INSULATIONISOUND
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL