06928 (SFD)P.O. BOX 1504. No. 06928
BuildinAddrress 78-580 Via ,Heledia LA QUINTACCALIFORNIA 92253 .
Owner
BARC014 DEVELOPHEUT BUILDING: TYPE CONST. OCC: GRP.
Address 68-713 Perez Read, #1 A.P. Number Tract #21555-4, Phase IV
City Cathedral Cgs ' Ip 92234 Tel -773.9024
Legal Description
Contractor . Y It: PARC LA QUIRTA
Project Description
Address
Plan 2222. (D), . i.ot #28
.
City Zip Tel.:
State Lic. City
& Classif. 3*37077 Lic. # 1219 Sq. Ft. 2,222 No. No. Dw.
Size Stories - x Units
Arch., Engr.,
Designer New CX Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address' Tel.
CityZip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm,that I am licensed,under provisions of Chapter 9,(commencingg with Secl on
7000) of Divisio/n,3 of the Business an'd,Professioris of Chapter
my, icense/is "h -I Il;force°and
effect.: / 1y°% <y'r s'' 7 1 i�'
SIGNATURE - /' 1 DATE
OWNER -BUILDER DECLARATION m Estimated Valuation
I hereby affirm that 1 am exempt from the Contractor's License Law for the following fi
reason: (Sec- 7031.5,Busi ess and Professions Code: Any city or county which requires a
Permit to construct, after, improve, demoM, or repair any structure, prior to Its issuance also
reprures the applicant nor such pemmft to We a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractors 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 Plan Chk. Dep.
subjects Me app8rant to a ciw7 penally of no more than rive hundred dollars.($500). A
❑ I, as owner of the property, or -my employees with wages as their sole compensation, will Plan Chk. Bal. 571.10-
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. �. ��
Professions Code: The Contrado's License Law does not apply to an owner of property who •
buds or improves thereon and who does such work himself or through his own employees, Mech. �� O� �
Provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is said within one year of completion, the owner -builder will have the burden Electrical �� ��
Of proving that he did not bund or krprove for the purpose of sale.) •
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 144.50
struct the project (Sec- 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 7.91
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec B. & P.C. for this reason
Driveway Enc. .
Date - owMr Infrastructure 2,523,63
WORKERS' COMPENSATION DECLARATION
I hereby affimm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No campy y '
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. r
TOTAL �'� • �%
CERTIFICATE OF EXEMPTION FROM REMARKS L Skid � '�5 t•#y?(I 1 r1 Sed tr �.i •f C)
WORKERS' COMPENSATION INSURANCE
(This section need not be corpfeted if the permit is for one hundred dollars ($ 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, after malmrg dors Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provsions of the Labor Code, you must forthwith
comptyrdhsuch Provisions offits pem*shall bedeemed revoked. . Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued- (Sec. 3097, CM Code.) Side Setback.from Property Line
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration it work thereunder is suspended for 180 days.
certify that I have read this application and state that the above information is correct. Issued by: Date Permit
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
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. g0, FT. ®
SEWER OR SEPTIC TANK(,
1�tOUGH WIRING.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
WALL SO. FT.
GAS (FINAL)
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.s
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROOFING 2'Z 0 P {�..,
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
SPARK ARRESTOR
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
THING V`
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
-rlke7 (JAW
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 6 AIR COND. SOLAR
SETBACK
GROUND PLUMBING 3aq d
tWDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK(,
1�tOUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
1r.o.• METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
%^ecu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.s
FRAMING 3 a
FINAL INSP.
ROOFING 2'Z 0 P {�..,
(/
REMARKS:
VENTILATION
FIRE ZONE ROOFING;
kEowfl-gy
FIREPLACE
l6t7
SPARK ARRESTOR
GAR. FIREWALL
U
THING V`
MESH
-rlke7 (JAW
L
/
INSULATION/SOUND
«
FINISH GRADING
C�V,+
FINAL INSPE ION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL
x���ixt�cx�
(t u a (Quinta
This 'Certificate issued pursuant
suant to the requirements of Section 306 of the Uniform
Worm Building*
Code -certifying that at the time of issuance this structure was in compliance with the various
ordinances of -the City
regulating. building construction or use. For the following.
787580 -Via Melodia
BUILDING' ADDRESS
Use Classification Single Family -Dweiling.- Bldg. Permit No. 06928
Group R3 Type Construction VN Fire Zone Use Zone SR
Development 68-713 Perez Rd. .Owner of Building Barcon Address
City athedral City. CA 92234 BYDanny Crawford''-
11
Date;
July 5, 1995'
Building Official
POST IN A CONSVICUOUS PLACIE.
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