002959 (ELEC)s
� lwQ�rw
P.O. BX 1504
Building Tract #1930.,, La Q1ib" P+rtlt:78-1 5 CALLE ESTADO
Address 79`259 Fred Waring DtiVe LA QUINTA, CALIFORNIA 92253
Owner
No. 002959
Mailing
BUILDING: 'TYPE CONST: OCC. GRP.
Address 127 W. �js� Amme.'n H A.P. Number.
City Zip Tel.
pjix*nt4ap CA. I SIMO 111710996-2000 Legal Description
Contractor Project Description TompozaXT 1117AW poll
-
B & H E1�C. iC
Address
City Zip Tel.
9==90 ;1 92256 363-7267
State Lic.
City
& Classif. 371359-<10
Lic. # Ct 4
Sq. Ft.
No. No. Dw.
Size
Stories "- Units
Arch., Engr.,
_
Designer _
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
_
City
Zip
State
Lic. #
LICENSED CONTRACSOR'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
- i effect.
SIGNATURE DATE
' OWNER -BUILDER DECLARATION
EStlfTlated ValUatlOn
.
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
the applicant for such permit to file a signed statement that he isdicensed pursuant. to
- PERMIT
AMOUNT -
therequires
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or thathe is exempt therefrom,. and the basis
for the Any 'Section 7031.5 by 'any fora
-
Plan.Chk. Dep.
alleged exemption. violation of applicant permit
' subjects the'applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk.. Bal.
❑ 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
Const.
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,
Mech. .
provided that such improvements are not intended or offered for sale..lf, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
Electrical
C
of proving that he did not build or improve for the purpose of sale.)
i+�� ,
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
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
S.M.I.
- ^
. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0 I am exempt under. Sec. B. 8 P.C. for this reason
•
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self-insute, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)..
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
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.
Date • "Owner
NOTICE TO APPLICANT: If, 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 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, CivdCode.)
Side Setback from Property Line
Lender's Name
Lender's 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. '
K
2/c71S7
I certify that I have read this application and state that the above information is correct.
Issued by:
Date Permit
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.
Validated by:
Signature of applicant Date
Mailing Address .
Validation:
City, State, Zip
B7497
3 11 _. 225G 9
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. p
ROUGH WIRING
GAR. - SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT.
HEATING (FINAL)
WALL SQ. FT.
REINF. STEEL
DRINKING FOUNTAIN
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
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 APP./EQUIP.
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
B
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
97
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL