003337 (SFD)4. 4,
P.O. BOX 1504 No.. 0,03337
{ Building78-105 CALLE ESTADO
I Address 45--4i'3°j -Dune Pals Remi #23 LA QUINTA,.CALIFORNIA 92253
Owner
pal 1 lRo al a BUILDING: TYPE CONST. OCC: GRP
Mailing:
Address A.P. Number D=4-- 'Pn.l x,* Mrsle4lfs 17ft114 a Pima
City Zip Tel. "
& Qu to . 92253 Legal Description
Contractor d Here Mobilea and. attached
_. Project•Ilescription
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Address. .. . .. ••��yy .. - _ patio em
er
F.
S a 0• BOX .755
City Zip • - Tei.
k Palm 3 >za 92258 379-2951
State Lic.
City -,
& Classif. _ -
Lic. # 1
Kc—_ t :moil, .
Sq. Ft.
No. No. Dw.
,
Size
Stories Units
Arch.; Engr.•,
Designer
New ❑ Add ❑
- Alter El- ❑ -Demolition ❑
Address
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 By and Professions. Code, and my license Is in full force and
.!r • -, r � �- �' f •
SIGNATURE DATE
._
- .._ .. .. .
OWNER•BUILDEWDECLARATION
Estimated' Valuation
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5:151usiness and Code: .city or county which requires a
-
.Pro/essions -Any
permit, to construct afar, Improve, demolish, or repair any structure,. prior to its Issuance also
+•
. - . -
regWrea-.'he eppfcamt-.for such permit to file -a signed statement that -he Is licensed pursuant to -
- .-PERMIT -
•- '. AMOUNT -
the: provlsbns o/ that Contractors License Law, Chapter 9 (commencing wIM Section 7000) of
Division *3 of'fhb Business and Professions Code, or_that.he la exert therefrom, and the basis
- for the 'Section 7031.5 by -'any for
Plan Chk. Dep.
-
alleged exemption. Any violation of applicant -a perm#
subjects the applicant to a clvl!'penafy. o/ not more than five' hundred dollars ($500): -
Plan Chk. Bal.
L ; 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
Const.1
Pro/eas(ona Code: The Contractor's License- Law does not: apply to. an owner, of property who
•If
builds or frnproves thereon and who does .such work himself or through his own employees,
Mech:
. provided that,such Improvements are not Intended or,o(fered for sale. ,M, however, .the building
-
or improvement is sold within one year of completion, the owner-buW r wlll have the burden
Electrical
of prolong. that he dM not: build or Improve for the purpose of sale:) -
❑ I, as owner of the property, am ezclusNely contracting with licensed contractors to con--
Plumbing
struct the project. .(Sec. 7044, -,Business and Prolesaion8 -Code: The Contractor's License Law
- -
doesnotapply to an owner of property who builds or -Improves thereon, and who contracts for
S;M;I• -
- -
such projects with a confractor(s) licensed pursuantto the Contractor's License Law.) --
Grading
❑ I,am exempt under Sec. - - B. & 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 -Insure, or a certificate -of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3600, Labor Code.).
Policy No -Company
❑";Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
1b 5, ire
CERTIFICATE OF EXEMPTIONFROM _
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 ths.work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject,to the Workers^Compensation
Laws of Califomia
Date Owner r j ,dl ' r
NOT/CEfTO CANT.- f afar making this Certificate of Exemption you' should `became
ZONE:
BY:
subject to' the Workers' Compensation provisions of the Labor Code, youmustforthwith'
comaywimsuch provisions or this pemlfshaft bedeemed reva"d. -
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Minimum Setback Distances:
Front Setback from Center. Line
Rear Setback from Rear Prop. Line
CONsTRUCTION'LENDING AGENCY
Side Street Setback from Center Line
Ihereby affirtn-that there is a construction lending agency for the performance of the
work for which this permit is Issued. (Sec.;3097, Civil Code.)
Side Setback from Property. Line
Lender's Name
Lender's Address,FINAL
DATE
INSPECTOR
INSPECTOR
This is wbuilding permit when properly filled out; signed and validated, and is subject to
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expiration if. work thereunder is suspended for 180 days.
I certify that I have read this that
P 25-87 Permit
application and state the above information is correct.
I agree,
•Issued by:,
Date
to comply with all city and county ordinances and state laws relating' to building
construction, and hereby authorize representatives '-of this city 4o enter 'the above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State,. Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. TT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. 0
POWER OUTLET
ROOF DRAINS
CAR P. I SO, FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO.. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
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
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® Vic
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMITTEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE JELECT.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
!/ y
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION 1n
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL