14404 (PLBG)414 4946
P.O. BOX 1504 No. 14404
Building 52-350 Ave. Herrera LA QUINTA, CALIFORNIA92253
Address -
Owner & Mrs. CaiiilleYmi3 Valdez .
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address Same
City Zip
92253
La Quinta,..'C_4
Contractor 7
Denboer Engineering & Construction
Advdr�es17 j . Berro' d Court
c8athadra" l +volt, 7;p CFS 922341'16'19)3'27-2260
A.P. Number
Legal Description
Project Description - eEfP_r. i°t}2311Q0
State Lic.
City
& Classif.. A B 684563
'Lic. #
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch.,-Engr.,
' -Designer
New ❑ Add ❑•
Alter ❑ - Repair•❑ -Demolition ❑
iAddress
Tel.
City
Zip
State
Lic. #
`� (� LICENCED CONTRACTOR;$ DECLARATION
I hefeby"vaffirm that I a licensed under Drovlsions of chapter,9 (commencing with Section
OOQj of Divisio_nt3 of t e B siness and Proesaions Code, and my license is ' -full force and
' eft' c ` /
NATU / r�- DATE
-
' OWNER -BUILDER DECLARATION!f
Estimated Valuation
$1 2� QWr
• I hereby affirm that I am exempt from .the Contractor's License Law for the --following
t .
reason: (Sec. 7031.5,Business and Professions Code: -Any_ city or county ,which -requires a
permit to construct after, Improve, demolish, or repair any structure, prior to its issuance also
' requires the applicant for such permit to.ffle 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
the
Division 3 of the and Professions Code, or that. he is exempt therefrom, and the basis'
for the Any Section by 'any for
Plan Chk. Dep.
alleged exemption. violation of ,7031.5 applicant a permit
subjects the applicant to a civil penalty of not more than rive 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.
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,
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
of proving that he did not build or improve for the purpose of sale.)
O I, as owner of the property, am exclusively contracting with licensed.contractors to coir
Plumbing
W
'• 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.L.
such projects with a contractors) [rcensed pursuant to the Contractor's License Law.) .. -
Grading
❑ 1 am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby,affinn that I have a certificate of consent to self -insure; or a certificate of
m
Worker's Copensatlon 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
30.00
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed N 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 any pperson In any manner so as to become subject to the Workers'. Compensation
Laws of Callfornia.
Date Owner
NOTICE TO APPLICANT: N, after making is Certificate of 'Exemption you. should become
sutiject to the Workers' Compensation provisions of the Labor Code; you must forthwith
comply with such provisions or this,permit shalt be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,'AND
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,
DAMAGES AS PROVIDED FOR IN. SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This Is a building permit when property filled out,.signed and validated, and is subject -to
expiration if work thereunder is suspended for 160 days.
I ceAlly 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 chis city to .enter the above-.
mentioned property for Inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
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: / �y,�, .t\•
r
1
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL, AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROUGH WIRING
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. I SO. FT.
HEATING (FINAL)
WALL SO. 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.
LAUNDRYTRAY
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
FIRE ZONE ROOFING
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® i'A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
LATHING
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 APPJEOUIP.
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