06908 (SFD)4
P.O. BOX 1504 N u •
Building 78-535 Via Scmata 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner '
BAARCON DEVELOPMENT
Address 6-73 Perez Road. #1
City%thedi^a ] Gi tV Zip 92234 1 Tet' 3- Z4
Address
Zip
State Lic.
337U77
Plan Chk. Dep.
& Classif.
Plan Chk. Bal.
(City
Lic. If
-Arch., Engr.,
0
Designer
Qu.. v
Address
120.79
Tel.
City
S.M.I.
Zip
State
Driveway Enc.
Validation:
Lic. #
•�
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm Jhatd am licensed under provisions of•Chapter 9 (co
7000) of Division 3'of•the Business and Professions Code, and my,lid
effect. r/
!8^ i �' G ! r r
is
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Bussoress and Professions Code: Any city or county which requires a
permit to construct, after, improve, demafsh, or repair any structure, prior to its issuance also
requires the applicant for such permit to hTe 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 the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a cha penally of not more than 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, Buisness and
Professions Code:. The Contractor's 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 improvements are not blended or offered for sale. If, however, the building
or improvement is sold within one year of cortpletion, the owner -builder will have the burden
of• proving that he did not build or kriprove 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.)
O 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
Worker's 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 thg 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: ff, after maldrg 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 Otis permit Shaff 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.)
Lender's Name
Lender's 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 Address
City, - State, . Zip
BUILDING: -TYPE CONST.O C: RP: _ .
Fa�,TZ #2 5 °J•' s tafa e i tl
A.P. Number
Legal Description _
uk Qu .
Project Description
batt t..4 L U) s Out V0
Sq. Ft. No. No. Dw.
Size . - Stories Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $1120 61
PERMIT
AMOUNT
Plan Chk. Dep.
_
Plan Chk. Bal.
^ = u
Const.
0
Mech.
Qu.. v
Electrical
120.79
Plumbing
DU
S.M.I.
7.51
1
Grading
Driveway Enc.
Validation:
Infrastructure9G
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TOTALS
REMARKS'
g t,
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
ROUGH PLUMB.
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
FORMS
SEWER OR SEPTIC TANK L�
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
DRAINAGE PIPING
CAR P. SQ. FT. ®
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
WALL SQ. FT.
GAS (FINAL)
TEMP. POLE
URINAL
Sp. FT. @
GROUT
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
=$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.s �2
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® V/ao
HOUSE SEWER
GAR. FIREWALL
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 s
n4UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEG®�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK L�
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)' g Oq TO
w
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL 20,t
o R�
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.s �2
FRAMING 3/719 w^
FINAL INSP. �<
ROOFING /L Ya
C �"�
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/�
LA G O .O "r GT
MESH
INSULATIONISOUND h
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL