05926 (SFD)Titif 4 4 a"
Building
Address 79-720 ilia Yfelodia
Owner
Bacon Dev.
P.O. BOX 1504
M-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address 68-713 Perez Rd. # 1
City Zip Tel.
Cdt City 9x234 773-9324
Contractor x n r
same
Address
State Lic. City
& Classif...337077 Lic. # 1219
Arch., Engr.,
Address ITel.
City(Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division/ 3 of the Business and fessions Code, and my license is in full force and
effect. / �k Y Y 1 +F
rl EFF/// F_+ I i J7 �'�'
r;S GNATURE C' { - _DATE_
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buskww and Professions Code: Any city or county which requires a
permit to construct, after, irpmve, demolish, or repair any structure, prior to Its issuance also
requires the applicant for such permit to lite a signed statement that he is licensed pursuant to
the provisions of the Cmbacibr's License taw, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Cade, 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
y subjects the applicant to a suit penafy of not more than five hundred dollars ($500).
❑-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 Contractors 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 rrprovanerts are not intended or offered for sale. If, however, the building
or Improvement is sold w3hin one year of completion, the owner -builder will have the burden
of proving that he dol not build or improve 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 projects with a 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
-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 ff the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thF 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 ovmer
NOTICE TO APPLICANT: If, after making this Certificate or Exemption you should become
subject to the Workers' Co�rrpensation provisions o1 the Labor Code, . you must forthwith
comply with such provisions or this Pemmit shat) 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, Civil Code.)
Lenders Name
Lenders Address
This'is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. '
I certity that 1 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 Addres
City, State, Zip
No. 05926
BUILDING: TYPE CONST: OCC: GRP. -
A; P..Number
Legal, Description rhElS@ 11 Lot 7
Project Description
Pian 2,004 -Parc La eta
Sq, Ft. 2004 No. No. Dw.
Size Stories Units
Newts Add O Alter O Repair O Demolition O
Estimated valuation
102,026.00
PERMIT
AMOUNT
Plan Chk.bep.
Plan Chk. Bal.
Const.
9i.t2?
Mech.
Electrical
INSPECTOR
Plumbing
Date !1i—g Permit
S. M. 1.
7.21
Grading
Validation:
Driveway Enc.
Infrastructure
229).59 -
TOTAL
3823.55^#"r
REMARKS��;r...,,��
<-.,. <aarx .• .,wv r,"__ _ �3
fii:�a a'.Y
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 !1i—g Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
SLAB GRADE 7/t % Y�4
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
STORAGE TANK
FORMS
SEWER OR SEPTIC AN
MOBILEHOME SVC.
BAR SINK
POR. SO. Ff. ®
FOUND. REINF.
G (ROUGH)//
n i METER LOOP
�� `ar
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
REINF. STEEL 7 01
AS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. Ff. @
GROUT
WATER HEATER
SERVICE
DRINKING FOUNTAIN.
WALL SQ. FT.
BOND BEAM
WATER SYSTEM
URINAL
SQ. FT. @
LUMBER GR.
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
INAL INSP.
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSPECTION
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
ll UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE 7/t % Y�4
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC AN
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
G (ROUGH)//
n i METER LOOP
�� `ar
HEATING (FINAL),
OTHER APPJEQUIP.
REINF. STEEL 7 01
AS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$-=$
LUMBER GR.
FINAL INSP.
FRAMING Z dG
INAL INSP.
ROOFING ff.?//J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHINGvvn% �b
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
1