06606 (PLBG)Building 51-020 Usenb mr
Address
Owner
Address
City
La 4tmilnta 192253
City 1- 92234
State Lic.
8 Classif. 410275
' u
P.O. BOX 1504
78&105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 06606
BUILDING: TYPE.CONST. OCC: GRP.
A.P. Number' 773-071--017
568-4777 Legal Description
Project Description Seepage pit
321 -744th
# 1136 Sq. Ft. No. No. Dw.
Size Stories Units
Address I Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that 1 am licensed under provisions of Chapter.9 (commencing with Section
Msion 3 of the Business and Professions Code and rnY license is in full force and
SIGNAT111tE DATE
OWNS WMILDER DECLARATION
I hereby affirm that am exempt from the Contractors License Law for the following
reason: (Seo. 7031.5.13usiness and Protassfans Code: Any city or county which requires a
Permit to coraftwt, .alter. Irmprove, demolish. or #Web any shucMe. pronto its Issuance also
rewdres Me Me rovisions oapplicant Lice tow, Chapter (corm sigmed statemard Met he � pursuant
o
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the pasts
for Me aHegad axertmtlon. Any violation of Section 7031.5 by any applicant for a permit
suojeets the RAPACOM to a c"Pervsily Wool more Mer five hundred dollars (1500).
❑ 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, Bufaness and
Phofessions Code: The Coebactora License Law does not appy to an owner of Property w/w
builds or Inproves thereon ant who does such wont himself or through his own empbye 7
provided Mer such tnnprovemerds are not Intended or offered for safe- n, however, the building
or 6npmvement Is sold wg* one year of completion, Me owner -builder will have the burden
of proving that he did not bulli or Grmmve for the purpose of sale.)
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Busfwss and Professions Coder The Contractor's License Law
does not apply to an owner of leapanp who binds or Irprores thereon, and who contracts for
such pno/®ctswuh a conbactor(a) 8ce nsedpursuant to the Coebectork License Law_)
❑ 1 am exempt under Ser< a d P.C. for this reason
Date owner
WORKEW 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. (See. 3800, Labor Code.)
Policy No Company
O. Copy is filed with the city. 0 Certified copy Is hereby furnished. .
CERTIFICATE OF EK MPrION FROM
MIORKERS'COMPENSATION INSURANCE
(nda section need not be r I:' Ig d If The paalf Is for one hundred dMars ($100) valuation
or less.)
1 cavity that in the performance of the work for which this permit Is Issued, l shall not
employ any person in any manner sous to become subject to the Workers' Compensation
Laws of California
Date Owner
N0710E TO APPLICANT: 8;. after mebw tlda Certilicate of Exampfion you should become
subject to the' W raers' Compensation ProMslams of Me Labor Code, you must forthwith
comply with such pmvlsiovs or this permft dW be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders Addrasa
This Is a building permit when properly filled out, signed and validated, and is subject to
expiration If work thereunder Is suspended for 180 days.
I certify that -I have read this application and state that the above. information Is correct
1 agree to comply will all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the. above:
mentioned property for inspection purposes
Signature of applicant bate
Malting Addrr�we
city, State, Zip
New ❑ Add ❑. Alter ❑ Repair ❑ Demolition ❑
PERMIT AMOUNT
Plan Chk: Dep.
Plan Chk. Bal.
Const.$ 334,W
Mech.
Electrical
Plumbing
S.M.I. .28
Grading
Driveway Enc.
Infrastructure
TOTAL fir• ``-,
REMARKS :T-�:r, r> , _ r _ __ .:_c•:r _ .
ZONE:BY:
Minimum Setback Distances:
_ Ffont Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE—INSPECTOR
qq
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SQ. FT. a $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SQ. FT. 0
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR SQ FT ®
ff'
ROUGH WIRING,
GAR. $Q_ FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAP P. SQ. FT.
HEATING (FINAL)
WALL SQ. FT:.®
REIN F. STEEL
DRINKING FOUNTAIN.
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
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, 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.
SQ. FT. RESID a 1% c
SEWAGE DISPOSAL
SQ.FT.GAR @ 114c
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
OONST. 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
EWER OR SE
ff'
ROUGH WIRING,
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REIN F. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-Xs-=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
\
S
.•%
V
Z
�,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINTTIALS
GARDEN WALL FINAL