14604 (PLBG)T144f
4
f�l'Gv
P.O. BOX 1504
Building 78-495 CALLE TAMPICO
Address 48--135 Via Solana LA QUINTA, CALIFORNIA 92253
Owner fdr. . & LTi: Er . Robert Friedrieks .
Mailing
Address Same
City
Zip
Tel.
i s . Quixata y A
92253
State
Contractor
" John White
Address
54--095 Velasco
City
La' Qiuinta, CA
Zip
92253
Tel.:
564-4239
State Lic.
City
& Classif.. C-�10 645444.
Lic. #
Arch:, Engr., '
Designer
Address
Tel.
No. 14604
BUILDING: TYPE CONST: -OCC: GRP.;
A.P. Number
Legal Description
Project Description g",ri for Pond
Sq. Ft. No. No. Dw.
Size Stories .-.Units
New El Add ❑ =. Alter ❑ Repair ❑ Demolition,O
Date Owner
NOTICE ,TO APPLICANT: ff, after making this Certififcate' of Exemption you should' become -ZONE: - BY:
subject to the Workers' 'Compensation provisions of. theLabor Code, you. must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback'Dlstances: '
Front Setback.from Center Line
Rear Setback, from Rear to . Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback fir nt Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
.HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from P y Line
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE. LABOR CODE, INTEREST, AND a
ATTORNEY'S,FEES.
This is a buildin properly g I FINAL DATE - I ECR
g permit whenfilled out; signed and validated, and is subject to n
expiration if work thereunder is suspended for 180 days:
I.certify that I have read this • application'and state -that the above information,is correct. Issued by: - Dat�+ • !F� mit
) agree to comply ws ith all city and county ordinances and state laws. relating to building
construction, and h
entiereby authorize representativeof -this city to 'enter -the above-. / 7
moned property for inspection purposes. Validated b
y
Signature of applicant Date
Mailing.Address Validation:
City, State, Zip
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby airm thaDta, icens�l under provisions'of Chapter 9 (commencing with Section
f'
7000),A f Division
3 ousin�e§sand Prdf ssions•Code, and my license is in full force and
fie t
sit
-SIGNATUREi DATE
-
' OWNER -BUILDER DECLARATION '..
Estimated Valuation '
$500
.hereby affirm that I am exempt from the Contractors License Law for the, following
i
_ reason: (Sec. 7031.5,Business and Professions. Code:; Any city or county which requires a '
permit to construct, atter, improve, demolish, or repair any.structure, prior to its issuance also
•. -
-
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
PERMIT ._ -
AMOUNT.
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
-
0lvlslon 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the -violation Section 7031.5 by 'any for
Plan Chk..0ep.
alleged exemption. .Any of applicant a permit
subjects the applicant to a chdl penalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
❑ I, as owner of the property,.or my employees with wages as their.sole compensation, wig.
do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and
Const.
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,•.
Mech:•"
- -
-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
EI@CtflCal '
A
3 A 0
- of proving.that he did. not WIN or improve for. the purpose or sale.) . .. �
G • N . .
❑ I, as owner of the property, am.exclusively contracting with licensed contractors to torr.
Plumbing
'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.
such projects with a contractors) jlcensed pursuant to the Contractor's License Law.)
_
Grading
0•1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner.
Infrastructure
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.) .
PolicyAJo. Company
ei Copy is filed with the city, .. ❑ Certified copy is hereby furnished.:
TOTAL
30.00 -
Q.®Q-
CERTIFICATE
CERTIFICATE OF EXEMPTION FROM
REMARKS •
WORKERS' COMPENSATION INSURANCE
.;
(This section need not be completed it the permit is for one hundred dollars ($100) , valua0on
' 'or less.)
I certify that in the performance of the work for which this permit is Issued, I shall not
employ any personnia - in any manner so'as to become subject to the Workers' Compensation
Laws of Califor
Date Owner
NOTICE ,TO APPLICANT: ff, after making this Certififcate' of Exemption you should' become -ZONE: - BY:
subject to the Workers' 'Compensation provisions of. theLabor Code, you. must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback'Dlstances: '
Front Setback.from Center Line
Rear Setback, from Rear to . Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback fir nt Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
.HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from P y Line
DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE. LABOR CODE, INTEREST, AND a
ATTORNEY'S,FEES.
This is a buildin properly g I FINAL DATE - I ECR
g permit whenfilled out; signed and validated, and is subject to n
expiration if work thereunder is suspended for 180 days:
I.certify that I have read this • application'and state -that the above information,is correct. Issued by: - Dat�+ • !F� mit
) agree to comply ws ith all city and county ordinances and state laws. relating to building
construction, and h
entiereby authorize representativeof -this city to 'enter -the above-. / 7
moned property for inspection purposes. Validated b
y
Signature of applicant Date
Mailing.Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. @ $
UNITS
COLL. AREA
2ND FL. S0. FT. @
ROUGH PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
SEWER OR SEPTIC TANK
ROUGH WIRING
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. I 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.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROOFING
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
SO.FT.GAR @ V4c
HOUSE SEWER
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
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
'HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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.
FRAMING
FINAL INSP.
ROOFING
� 6Gag rc- �-
l/Q �
be—
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL