14977 (BLCK)f
4.4 Q"..
P.O. BOX 1504
Building47-515-VIA lit�a`�� 78-495 CALLE TAMPICO
AddressLA QUINTA, CALIFORNIA 92253
Owner
MANNIES CONST
Mailing* T
Address 154.3 . OESE FALLS DR
..City 112260
Tel.,
PAM DEP��R� 34,..35,.2
Contractor
. . STEVt EM.INGTON MASONTRv
<` Address -.
k 69-675 PANORM . R.D
City � Zip Tel.:
C..C224 3zt3-948i
State Lica City
& Classif. 437804 Lic. # 3617
Arch., Engr:,
Designer
Address Tel.
No. 14977'
BUILDINGS TYPE CONST. OCC: GRP.
A.P. Number
Legal Description '
Project Description 6OFT OF. 5FT MTIL -
21FT OF 4F2 WALL
Sq. Ft. No. No. Dw. •:
Size Stories •- -Units '
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm th.t I am li>ied under provisions of Chapter•9 (commencing with Section
7000) of Divisiom,3 f the Usiness and Professions Code, and my license is in.full force and ••
,effect.
_
$1GNATURE ;0 DATE
' OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
a �{�
reason: ,(Sec. 7031.5,Business 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 rile a signed statement that he is licensed pursuant to
• the provisions of the Contractor's License Law, Chapter 9 (commencing with Secticn 7000) of
-
I
PERMIT - AMOUNT
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 rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
-
Plan Chk. Dep. -
Plan ,Chk. Bal.
r
Const. 54. J4
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
ML3ch..
builds or improves 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
Electrical. - -
- or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or Improve for the purpose of sale.)
Plumbing,
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Coder The Contractor's License Law
does not apply to an owner of property who builds or Improves thereon, and who contracts for
S.M.I.
such projects with contractors) #tensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason
Grading
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
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
0 Copy is filed with the city... O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
-• WORKERS' COMPENSATION INSURANCE
(This section need not be completed.ff the permit is for one .hundred dollars ($400) valuation
or less.)
I certify that in the performange of thip w�U for which this permit is issued; 1 shall not
employ any parson in any manneF of t. , ecome subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT, ti, after making this Certificateof 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. - -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. f
Ttiis 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.
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
TOTAL
REMARKS
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 INSPECT -OR
Issued by
Validated
Validatior
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SD. FT.
GAS (ROUGH)
DRINKING FOUNTAIN
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL. FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
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 ® 1+/e c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
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
ROCKSTORAGE
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
REMARKS:
VENTILATION'
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESlINITIALS
GARDEN WALL FINAL