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07260 (SFD)4 �a . P.O. BOX 1504 N Q , 07260' BuildinAddrress $" SBV tld LA QUINTACCALIFORNIA 92253 /Deane Rows BUILDING: TYPE CONST OCC: GRP: A.P. Number 613'4024004' 009' 016 Legal Description Tent.T�'. �0. 2397 Project Description Pha S$% I — A - Mailing Address 15 .Agusta -Drive City zip Rancho Mir -19e -92270 Tel. 32`1..80.0 Contractor Sate-- - work for which this permit is issued. (Sec. 3097, erg code.) Lot 12 Address Lenders Address FINAL DATE INSPECTOR City Zip Tel.: 9/ L q '(0Permit- I certify that I have read this application and state that the above information is correct. ' State Lia & Classif-, gG� City Lic. # Sq. Ft. 27€ 0 . R Size . No. 1-k S�i1 i t No. Dw. Stories Units Arch., Engr.;' New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑, .Designer Address' Tel. Signature of applicant Date Mailing Address Validation: ----- City Zip State " Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 am Iicegpe"nder previsions of chapter 9 (commencing with Section 7000) of DN inion 3 of Me Business " Pro wns Code, and my license is in II foarcey and. � ' effect gz'm � i - `•' ' _ . SIGNATURE DATE " OWNER -BUILDER DECLARATION hereby affirm that l am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Bus ess 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'peml to file a signed s statement that helicensed pursuant to the provisions of the Canbactors License Law, chapter 9 (commencing with Section 7000) of Division 3 of the Business and I'vigessions Code, or that. heis exempt therefrom, and the basis .. for the alleged exemption.,Any violation of Section 7031.5 by 'any applicant for a permit subjects the appbwnt to a avo penally of not more iron 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, Lindsness and Th ' Professions Code: e Contactors License Law does not apply to an owner of property who buWs or irproves therein and who does such work himself or through his own employees, provided tat'such inprovements are not intended or offered for sale. ff, however, the b -V -g or unprovement' is saw -'w@hir, one year of conoetion, the owner-bufider wig have the burden of proving,thathe did not buil or improve. for the purpose of sale.) Estimated Valuation �y��i $134,038 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal.3t1 • (3a Const. Mech. _ Electrical , . 135.98 Plumbing •L 138150 111, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project (Sec_ 7044, Business and Professions Code: The Contractors License Law does not appyto an owner of property who builds or irproves thereon; and who contracts for • such projects with a'coneractor(s) faensed pursuant to the Contractor's License Law.) • 11I -am exempt under Sec. a g P.C. for this reason S.M.I. 9445 Grading Driveway Enc. Date owner Infrastructure9 l WORKERS? COMPENSATION DECLARATION I hereby affirm that 1 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. _ TOTAL 7, CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit s for one hundred dinaws ($100) valuation or less.) - I certify that in the performance of tip 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 REMARKS + t 1 Ms .L 4" 1-40-ty ,V ' fly I Ab.. F'4 I:.is.75" 3 a a7 ! '• . Date owner N017CE TO APPLICANT: 9. after making Bis Certificate of Exemption you should become sufrjeet to the Workers' compensation provisions of the Labor Code. you must forthwith complywithsuchprovis;orsor Onpermit shall bedeemedrewked. ZONE: BY: - 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, erg code.) Side Setback from Property Line Lenders Name Lenders Address FINAL DATE INSPECTOR 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. 9/ L q '(0Permit- I certify that I have read this application and state that the above information is correct. ' Issued by: Date G 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 Vallljated 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 SLAB GRADEUGH PLUMB. Of YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ HEATING (ROUGH) STORAGE TANK MOBILEHOME SVC. BAR SINK POR. Sp. FT. ® ROUGH WIRING GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS (ROUGH) DRAINAGE PIPING CAR P. SQ. FT. @ HEATING (FINAL) OTHER APPJEQUIP. WALL Sp. FT. GAS (FINAL) DRINKING FOUNTAIN. TEMP. POLE URINAL SQ FT ® GROUT WATER HEATER ESTIMATED CONSTRUCTION VALUATION $ SERVICE 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 FINAL INSP. 4 C GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROOFINGL LAUNDRY TRAY AIR HANDLING UNIT CFM " %, L -P 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. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING 31 2, Cjd s. MESH 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 SETBACKJeGOAS OUND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADEUGH PLUMB. Of BONDING HEATING (ROUGH) STORAGE TANK FORMSWER OR ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF.� /)i vv (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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. 4 C FRAMING 17((� �d FINAL INSP. ROOFINGL TP a� pit ,��q� AK�� ' D ?1q ¢0 �< <Q �� " %, L -P REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 31 2, Cjd s. MESH INSULATION/SOUND 0 lZ 4d L FINISH GRADING FINAL INSPECTION CERT. OCC. IP FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS GARDEN WALL FINAL k