05496 (SFD)TW�l 4 4 a"
P.O. BOX 1504
Iding .48-115 Vista Clego 78-105 CALLE ESTADO
Iress LA QUINTA, CALIFORNIA 92253
Abe & Thelma Croserwiln
ling
Iress 9f82C Corbin Me. S.3
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect
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r�
SIGNATURE G / DATE
i OWNEWBUILDER DECLARATION
{ I hereby affirm that I am exempt from the Contractors License Law for the following
• 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 lire a signed statement that he islicensed 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 civra penalty of not more than five hundred dollars (8500).
0 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 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
of proving that he did not build or knprove for the purpose of sale.)
01, 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.)
0 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
JO Copy is filed with the city. 0 Certified copy -is hereby furnished.
F CERTIFICATE OF EXEMPTION FROM
' WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
f 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., fl, after making 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 this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
'. Ihereby 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 abuilding permit when property filled out, signed and validated, and is subject to
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.
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. mass
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 6.17-640-4M5
Legal Description Lot 45
Project Description P14M 1
Zip
Tel.
City
Nmthzed8e
91324
819/349-5894
Contractor
I Jas C. Cashman
Address
77-20
City
Zip
Tela
I Valm Desert
92260
619/345-5430
State Lic.
City
8iClassif. 8 195333
Lic. # 260
Arch., Engr., .
Designer
Address
I Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect
ir�:l:.r?-rt/'> ,. .G'r%i G�../.✓r`i';j'�yrf ,...,. ..:,.1�'t
r�
SIGNATURE G / DATE
i OWNEWBUILDER DECLARATION
{ I hereby affirm that I am exempt from the Contractors License Law for the following
• 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 lire a signed statement that he islicensed 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 civra penalty of not more than five hundred dollars (8500).
0 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 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
of proving that he did not build or knprove for the purpose of sale.)
01, 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.)
0 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
JO Copy is filed with the city. 0 Certified copy -is hereby furnished.
F CERTIFICATE OF EXEMPTION FROM
' WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
f 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., fl, after making 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 this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
'. Ihereby 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 abuilding permit when property filled out, signed and validated, and is subject to
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.
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. mass
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 6.17-640-4M5
Legal Description Lot 45
Project Description P14M 1
�HLMARKS• _
ZONE:
BY:
Minimum Setback
Distances: .
Sq. Ft. 152 No.
Size Stories
No. Dw.
Units
New1b Add ❑ Alter ❑
Repair ❑ -Demolition ❑
Side Street Setback from Center Line
Side Setback from P,�ope�y4Line
FINAL DATE
INSPECTOR
Estimated Valuation $96,142.00
\Issued by:
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
522.54
Const.
626.00
Mech.
60.00
Electrical
107..28
Plumbing
132.5U
S.M.I.
6. T9
Grading
Driveway Enc.
Infrastructure
2*163419
Fringe -toe
D
TOTAL
I "`_ �r .+.,(o
�HLMARKS• _
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 P,�ope�y4Line
FINAL DATE
INSPECTOR
3/14/89
\Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
ROCK STORAGE
FOUND. REINF.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. I SQ. FT.
^ Olv TEMP. POLE
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT a
SERVICE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
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
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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. 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 ® 3/4c
HOUSE SEWER
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.
llioS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEELW14
x—'
^ Olv TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
CU. yd.
—plus—x$—=$
LUMBER GR. INAL INSP. �'
FRAMING .0/( FINALA4 INSP.
ROOFING ��/fin
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWAL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
cuirc n�in�
r
/r
J
- -
.
REMARKS:
SIGNATURESIINITIALS
GARDEN WALL FINAL