04926 (SFD)44
P.O. BOX 1504 No. 04926
7&105 CALLE ESTADO
Address 78-'695 Via Co rrido LA QUINTA, CALIFORNIA192253 _
Owner
Bag Con Development
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 68--713 Perez Road � . A:P�Number � arc, La Quinta
• - - '� - ,
City Zip Tel..,
Cathedral city 922341 ,,77,3,•w9QZ4 _ Legal Description
ContractorPlan
2017— Lot46Same Project Description
Address
AMOUNT
City
Zip
Tel.:
-368.85
State Lic.337977
Sr Classif.
City 1219.
Lic. # - _
2 017 2
Sq. Ft. No.- No.'Dw.
Size Stories Units
Arch.,-Engr.,
Designer
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address,
Tel.
'de .00
S.M.I.
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 full force and
effect. j+ . , '1--/
/ w»-»'-�.^-,�.`^�.-. `
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,Busfness and Professions Code: Any city or county which requires a
permit to constrict, after, improve, demolish, or repair any structure, prior to Its issuance also
requires the applicant to' 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 ($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 inproves 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 sod within one year of completion, the owner -builder will have the burden
of proving that he did not build or inprove for the purpose of sale.)
❑ 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 projectswitha contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & 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
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 it 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: IF, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must , forthwith
compry 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, CM/ Code.)
Lender's Name
Lender's Address
This is abuilding 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.
Signature of applicant Date
Mailing Address
City, State, Zip
stimated Valuation
$102,026
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
-368.85
Const.
440.50
Mech.
42..00
Electrical
79,.50
Plumbing
'de .00
S.M.I.
7.18
Grading
Driveway Enc.
Validation:
Infrastructure
2,295.59
TOTAL
$3$327.52 ,r -% >ys 3 G
REMARKS
'
p. { rrroro,, fi
.�f$�.].'.".r►�i�. r:l6f �,?tipA= �y5 �ry�..,t�,�.,� .a ,� �«�
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
12/19/�3�
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE Z
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) `0_29 METER LOOP
!aI
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
GAS (FINAL) TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL SO. FT.
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$
=$
URINAL
SQ ®
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
G FIREWALL
I
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
Of
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
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.
SO. FT. @ c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ic
HOUSE SEWER
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
D PLUMBIN UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE Z
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. Z
GAS (ROUGH) `0_29 METER LOOP
!aI
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR. 11-7 FINAL INSP. 0 9 Q
a
FRAMING vv AL INSP.
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
G FIREWALL
I
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
Of
/
/ %
/
REMARKS:
SIGNATURESIINITIALS
GARDEN WALL FINAL