06934 (SFD)T4ht 4 4 Q"
Building
Address 78-515 Via Corrido
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner
BARCON REVEL PHST
Address 6'�7i3 Perez Road, 01
City Cathedral Cit Zip 92234 Tel. 773-9024
Contractor
Address ..
Tela
State Lic. 33Ta77
City 1219
& Classif.
Lic. #
Arch., Engr.,
Designer
Address-
Tel.
City
Zip
State
Lic. #
f'5,7, UCENSED CONTRAcrows D
1 hereby affirnm that 1 am licensed under provisions of
XI0) of Divisioon,3 of the Business a�n�dvProfession"s Cc
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,8usdness 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 filo a signed statement that he is licensed pursuant to
Me
provisions of the. Contractors License Law, Chapter 9 (commencing with Section 7000) of
Division 3 bf 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 din? penally of not more than Frio hundred dollars ($500).
D 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 udended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner•burlder will have the burden
of proving that he did not build or improve for the purpose of sale.)
D 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 bunds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
D I am exempt'under Sec. R. & P -C. for this reason
Date Owner
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. 3800, Labor Code.)
Policy No. Company
D Copy is filed with the city. D Certified copy is hereby fumished.
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: ff• 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 shag 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, Cfvg Code.)
Lenders Name
Lenders Address
This is a building permit when "property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days. '
1. certity 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
No. 06934
BUILDING: -TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description
Tract #2155$4, Phase V
PARCIA QUINTA
Plan 1620 (A)9 Lot 05
Sq. Ft. a�2�
Size
No. No. Dw.
Stories Units
NewJ0 Add O Alter O Repair O -Demolition 0
Estimated Valuation
X4,822
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
480 .68
Const.
572.€ 0
Mech.
65.50
Electrical
99.80
Plumbing
120.50
S.M.I.
5.95
Grading
Driveway Enc.
Infrastructure
11908,50
✓ r
TOTAL
�a...�},
REMARKS
. r_r z cx,•Ya-a-.tt;._/._u„___ x
TO
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. a $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
TROUGH WIRING
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (ROUGH) /
S
DRAINAGE PIPING
CARP. SQ. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
WALL SQ. FT.
GAS (FINAL)
DRINKING FOUNTAIN
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOI(DISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ plus x$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP. •• 1
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
GAR. FIREWALL
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
2,A/96
fZLONDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS O
SEWER OR SEPTIC TANK(
TROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) /
S
�r�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. / dj� Q
(tvY c
FRAMING 125—
FINAL INSP. •• 1
ROOFING
Pt J r -p
3 /rT >�D p�
7 (G ` f
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING 1a
MESH
INSULATIONISOUND l2�(
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL