06915 (SFD)4
P.O. BOX 1504
Building 78-580 Via SonaU 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
BARCON DEVELOPMENT
Address 68-713 Perez Roads 91
CityCathedrai City Zip 92234 TeI.F73-9024
Contractor
State Lic. 337077(City 31219
& Classif. Lic. #
Designer
Address Tel.
City P Zi State
/? I I Lic. #
�` LICENSED CONTRACTOR'S DECLARATION
;I hereby affinndhat I am licensed. under provisions of Chapter 9 (cc
of Division 3 of the. Business and'Profess ons Code, and,my lit
OWNEWBUILDER DECLARATION 1
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Btsbness and Professions Code: Any city or county which requires a
Permit to construct, after, brprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rde 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 avd 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
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 inproves thereon mid 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
or improvement is sold within one year of completion, the owner -builder will have the burden
or proving that he did not budd or knprove 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
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'COMPENSATIONINSURANCE
(This section need not be completed 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: H, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply wiUn such Provisions or this Permit shall 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
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 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
No. 06915
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Tract 021555-4. Phase IV
Legal Description �t��
Project Description PARC �TA
Pian 1620 Wl, Lot #15
Sq. Ft.
Size
New X1
1,620 No.
Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ -Demolition ❑
;timated Valuation
$84,822
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.•
Const. t
5 • 00
Mech. '
ti . 50
Electrical
99. SO
Plumbing
i —.59-
5
S.M.I.
S.M.I.
- J
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
r�a>~•.ra,. ,1�+ci rsa _.),f, .Ger>.,, .-� 6Ft
X�..A•tsra,v r .k'--s�c1y?t -
s'- W.,..._...::� -
ZONE: BY:
Minimum Setback Distances:
Feont 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. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS I
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL' SQ. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SQ FT ®
GRADING
cu. yd.
$ plus x$
=$
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. Q aC
FLOOR DRAIN
MECHANICAL FEES
-3/?/,, lIO�
f
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
INSULATIONISOUND�
SQ.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
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
CANDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS I
SEWER OR SEPTIC TANOUGH
WIRING
Vim
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
VIN 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. &,,e jo,
FRAMING 3// 7 ,l
FINAL INSP. Q aC
ROOFING 2_
-3/?/,, lIO�
f
p �1
f1
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA RING Z �� q'(/-1
MESH
INSULATIONISOUND�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1