14963 (RPL)P.O. BOX 1504 No. 14963
.Building 78-495 CALLE TAMPICO
Address 44-'790 N. Harland LA QUINTA, CALIFORNIA 92253
Owner Alphonao
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address Same
A.P. Number
CityZip Tel.
Zees Quints, CA 92253 Legal Description
Contractor iooI and spa
Pb01 Project Description
A Address
.P.O. B02C 11206
idesert, ip 92255 Tel.. 345-5070
State Lic. City
& Classif..C_53 476807 Lic. # 130 Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition O
Address Tel.
City Zip State
Lic. #
JawAICENSED CO3FRACTOR'S DECLARATION
I hereby afflrmi that licensed Littler prowsi sof Chapter g (commencing with Section
7000) of DNlsl 9usir s�arn�d—P--ro-tesal' Code,.and my license is inJfyli forc�,and.
effect. •�,,...-_ - . .�'i+fb,.
SIGNATURE - - S DATE
OWNER -BUILDER DECLARATION Estimated Valuation $.15r500.00-
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason:. (Sec.. 7031;5:Bushoss .mrd Professions Code:. Any. city or county ;which requires. a . ' -
Perri to construct: ager, hrpmve, demoBsh, or repair,any structure, Prior to Its. issuance. also .. .
repulses the.eppBcanr for such -permit to 8h a signed statement that 'he is ncensed pursuant to PERMIT - AMOUNT -
the provisions of the Ca . -1 orlk License Law, Chapter 8 (commenc/np - with Section 7000) of -
D/vlslon 3- of the Buaheas and Professlona Code, or, Met. he is exempt Iherefnom, and the basis
for Me alleged ,Any vkQ#w of Section 7031.5 by any applicant for a permit Plan Chk: Dep:
appacerit
subjects the to a cir8 penalty of not more than five hundred dollars ($500). ss •
❑ I, as owner ohthe property, or my employees withmages 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 COf1St:WW
Professions Cade: The Contractor's. License Law does. not eppry to an owner of property who
builds or Improves thereon mid who does such work hbnaeir or through' his own empbyees,- w v
Mach.
provMed Mat -such hupnovmrleri;a--are nof'htended or offered for sale. H,however, the building
of Improvement Is sold wHhh one ,year of ompfelbn,. the owner -builder will have the burden Electrical e
of proving Met'he.dM not bold or &Wove for the purpose of sale.) _
O I, as owner oFthe property, am exclusively contracting with licensed contractors to coo- Plumbing
struct the project (Sec. 7044, Business and .ProfessAms Code: The Contractor's License Law
does not apply to an, owner of property 'who .bul<da or Improves thereon, and who contracts for S.M.I.. -
'such pro)eats with a ccntrador(s) 8censed. pursuant to the Contractor's Lkense Law.) -
Grading
❑ I cexempt under Sec_ a. 8 P.C. for this reason
trl
Driveway Enc.
,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 Iumished. ,
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need ,not be canvbW. H the permit is for one hundred dollars ($100) valuation
or teas.)
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 Ceiifomia
Date Owner
NOTICE TO APPLICANT: H, ager making this Cedltkate of Exemption you should become
'MAID&
ZONE
BY:
to the Wbdmm' compensation Provdsloms of the Labor Code. you must forthwith
comply with such provisions Lir itis permit shall be deemed revoked.
.
Minimum •Setback Distances: - -
Front Setback from Center. Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND*
Side Street Setback from Center Line
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. Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
' .This
FINAL DATE
INSPECTOR
is a building permit properly filled out; signed and validated, and Is subject to
- expiration if work thereunderr is suspended for 180 days. -
1 certify that 1 have read this application and state that the above information is correct.
Issued. by:
Date
I agree to comply with NI city and county ordinances and state laws relating to building
construction, and hereby this
authorize representatives -of city to enter the above-.
mentioned property for Inspectlon purposes
Validated by:
Lr
Signature of applicant Date
Mailing Address
Validation:
11.4 k�
City, State, ZI
IVIMIAc
Y
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
IST FL. SO. FT. ® i
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME=SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION i
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuatlon
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK I-`
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEWPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. a c
BATH TUB
SO. FT. a c
WATER HEATER.
MAX.. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 114 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR a 34c
HOUSE SEWER
LATHING
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.
i plus xi
=i
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