06937 (SFD)T4hf- 4 4 a"
Buildin
Address 78—Via Co r rido
Owner
BARCON DEVELOPPIENT
Mailin
Address 68-713 ,Perez Roads #1
City Cathedral Ci .-Vip 92234 Tel. 77
Contractor
Address
Zip
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
State Lic.33T ay7 I City 1 X19
& Classif. Lic. #
Arch., Engr.,
Designer
Address' I Tel.
City (Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm thio J&am licensed under, provisions of Chapter 9 (commencing with Section
70(K>) of Division,3'of the Business and.Professions'Code, and. my license isin Rill.force and
effect. / yy r %" c s� ✓ r r - f0
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,8usiness and Professions Code:. Any city or county which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for 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 thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars (5500).
❑ 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
Professions Code:. The Contractor's License Law does not apply to an owner of property who
builds or unproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended .or offered for sale. ff, however, the building
• or improvement is sold within one year of completion, the owner -builder wig have the burden
of proving that he did not build or improve for the purpose of safe.)
❑ 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 projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ I 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
Workers 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 if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become 'subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code.
. you must forthwith
comply with such provisions or this permit shall be deemed revoked.
. . CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of. the
work for which this permit is issued. (Sec. 3097, CIO Code.-) .
No. 06937
BUILDING: TYPE•CONST.OCC: GRP.
Tr ct 41555-5. Phase
A.P. Number
Legal Description
(Project Description PARC LA QPIKA
Plan 2004 (0, Lot 0$
V
Lenders Address
FINAL DATE INSPECTOR
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.
Sq. Ft. 2,004
Size
No. No. Dw.
Stories - Units
New Add.❑ Alter ❑ Repair ❑
Demolition ❑
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City,. State, Zip
Estimated Valuation
$1d2iD26
S
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
�♦
Const.�tide'tl�
Mech.
Electrical
i 3i
Plumbing
. a
S.M.I.
Grading
Driveway Enc.
Infrastructure
Z, Leg!). J
TOTAL
s ./
REMARKS �xx _ , p�qq• <,
.�. C��+,E, f.,Ka yi.1 �F•; �1 (~797St.4 �'.t{ a,2F:f �r:w Jy3 w..i
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
Lenders Name
Lenders Address
FINAL DATE INSPECTOR
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.
Issued by: Date Permit
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.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City,. State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
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) ��
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SD. FT.
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO FT ®
-$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FRAMING Vzi ba ems....
WATER PIPING
NOTE: Not to be used as property tax valuation
�� Y `2
l' 7
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRYTRAY
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 ® 11A c
SEWAGE DISPOSAL
INSPECTOR'S SIGNATURESIINTTIALS
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
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�Vl
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. l Zv i1
�C
FRAMING Vzi ba ems....
FINAL INSP.
ROOFING
�� Y `2
l' 7
0 ez,—
REMARKS:
/57
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING q f 7110 ,.
MESH
INSULATIONISOUND 3
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINTTIALS
GARDEN WALL FINAL
l