Loading...
04986 (BLCK)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 54-305 Herrera LA OUINTA, CALIFORNIA 92253 Owner Mailing Address xt all City _ Zip - — s Tel.' Rialto 92376 -- Contractor Address Tel. State Lic. I City & Classif. 2 11 117q Lic: # Arch., Engr., Designer Address I Tel. City (Zip( State Lic. # LICENSED CONTRACTOR'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 effect. . T r til i, K SIGNATURE '" - - 'DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8usiness 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 rite 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 One applicant to a civil penalty of not more than Ore hundred dollars ($500). ❑ 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 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. it, however, the building or improvement is sold within one year of completion, the owner-buRder win have the burden of proving that he did not bund or improve for the purpose of sale.) O 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 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.) ❑ 1 am exempt under Sec B. & P.C. for this reason Date Owner i WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I 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 No Company ❑ Copy is filed with the city. ❑ 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 ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: h, alter making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the,Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY ..I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip 0 No. 04986 , BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-245-015 Legal Description Project Description -98 lin. f t ., X 3 f t . rat rr. is in g, dft1t t Sq. Ft. No. No. Dw. Size •. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation s PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. %5,....T Const. Mech. Electrical Plumbing INSPECTOR S.M.I. Date 12 x I Permit Grading Driveway Enc. Validation:_ Infrastructure TOTAL .4 ; REMARKSs_.... ,$�yX .� M-1 JQ 2_7 - YAN 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 12 x I Permit Validated by: Validation:_ __ __ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT COLL. AREA YARD SPKLR SYSTEM 2ND FL SQ. FT. 0 ROUGH PLUMB. BONDING MOBILEHOME SVC. BAR SINK POR SQ FT ® FORMS SEWER OR SEPTIC TANK POWER OUTLET ROOF DRAINS GAR. SQ. Fr. ® DUCT WORK ROCK STORAGE O. REINF. _! DRAINAGE PIPING CAR P. I SQ. FT. METER LOOP WALL SQ. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN. SQFT ® GAS (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation GROUT FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 Vi c SEWAGE DISPOSAL SQ.FT.GAR ® 3/.c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE In 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 O. 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 ��./ //'�) / ✓ . ✓ - l" -J . r � //�( /% , 2 � �� li (!rte` REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL (&XLATHING //MESH 1/ UNSULATIONISOUNO -� l� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL Building-:�Y— '!O� Address Lot -3 Hprrp Bob Moore & Robert JONES P.O. BOX 1504 APPLICATION ONLY 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address P.O. Box 921 City Zip Tel. Rialto, Ca. 192376 [ Contractor BUILDING: TYPE CONST. OCC. GRP. P. Number 771-71.5-01 5-7 Legal Description Project Description Address 515 W. Rialto Ave. ' 4 City Zip Tel.. Rialto, Ca. 192376 714 875-6000 State Lic. City & Classif. 261079 B-1 Lic. # Sq. Ft. 1517 Stories 1 No:UniDw. 1 Arch., Engr., Designer New)] Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereb affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of - i ion 3 of the Busl ess and Professions Code, and my license is in full force and effect. � J^����� / _SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the followng Estimated Valuationng 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 file 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 (5500). 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, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds 0,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.) GGV// PERMIT AMOUNT Plan Chk. Dep. "y 5' 0. O n Plan Chk. Bal. Const.O� Mech. ev Electrical Plumbing r O I, as owner of the property, am exclusively contracting with licensed contractors to con- Strutt 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O I am exempt under Sec. B. 8 P.C. for this reason S.M.I. / Grading . Driveway Enc. -Zd ev Date owner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I 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 No. .Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 4 o 6 { 71. AS— f h—ISA i (This section need not be completed if the permit is for one hundred dollars ($100) valuation,t•ty,r or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any m or so as to become subject to the Workers' Compensation Laws of California. .. IOJ C,N 1 `tU`TAL i r 5 • tau Dat@ OC3AKD wner NOTICE T�CANT: 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. ZONE: BY: Minimum Setback Distances: ` - a' Front Setback from Center Line Rear Setback from Rear Prop. Line 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.) Side Street Setback from Center Line Side Setback from Property Line Lender's Name FINAL DATE INSPECTOR 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 -of this city to enter the above-. mentioned property for inspection purposes. Issued by: Validated by: Date Permit Signature of applicant Date Mailing Address Validation: City, State, Zip BUILDING DIVISION r; CONSTRUCTION ESTIMATE GROUND PLUMBING NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. ® E % 3� UNITS BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING YARD SPKLR SYSTEM 2ND FL. SQ. FT. ® FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL MOBILEHOME SVC. TEMP. POLE BAR SINK POR. SQ. FT. ® GROUT WATER HEATER SERVICE FINAL INSP. y GAR. SO. FT. ® ' ( S 1709 POWER OUTLET ROOF DRAINS LUMBER GR. FINAL INSP. DRAINAGE PIPING CAR P. SQ. FT. ROOFING WALL � SQ. FT. REMARKS: VENTILATION DRINKING FOUNTAIN SQ. FT. FIRE ZONE ROOFING URINAL ESTIMATED CONSTRUCTION VALUATION $ FIREPLACE WATER PIPING NOTE: Not to be used as property tax valuation SPARK ARRESTOR FLOOR DRAIN MECHANICAL FEES LATHING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINISH GRADING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSPECTION LAUNDRY TRAY AIR HANDLING UNIT CFM CERT. OCC. KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP GARDEN WALL FINAL POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT 1?1 SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE 7P0-- PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT.FEE SMI FEE PLUMB. FEE Z 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