05518 (SFD)Building
Address
t
Mailing
Address
City
48-120 Vista Cielo
Abe & Thelm Grg stt an
9010 Oor'bin Ave. S.3
Zip
1 Harthridse 1 91324
Contractor
1
Address
City
Pala
State Lica
& Classif.
Arch:, Engr,.
Designer
Address
E
City
James C. Cashman
7.7-200 Himesota
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
• f c
No. 05535
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number 617-640-066
el. Lot 66
816/349--5896 Legal Description
Project Description 6
Zip Tela
Desert 9226 619-345-5430
City
B 195333 Lic. # 26o
9
Tel.
Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I! 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 I II II ce nd"
effect �..: �'.4 T r� . /.%• iii: _1 . �.
SIGNATURE tDATE
f OWNEWBUILDER DECLARATION
F 1, hereby affirfn that 1 am exempt from the Contractor's License Law for the following
reason: -(Sec;, 7031.5,Busbhess and Professions Code: Any city or county which requires a
pemrit [o cwnsfrrrcL after, improve, demolish, or repair any structure, prior to. its issuance also
ro9ulres the 19=1 int for such pend to fie a signed statement that he is licensed pursuant to
the provisions of the Contractors 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 pend
subjects the applicant to a an7 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 Contradoes License Law does not apply to anowner of property, who
butkds or -reproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for safe. 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 errprove for the purpose of sale.) 0! 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project- (Sec. 7044, Business and Pro/essions 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.)
i
❑ .1 am exempt under Sec B. & P.C. for this reason
j
Date Owner
WORKERS' COMPENSATION DECLARATION i
1 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 '
}}I1�Copy is filed with the city. ❑ Certified copy is hereby furnished.
1 CERTIFICATE OF EXEMPTION FROM
WORKERS• COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars (8100) valuation
or less.)
I I certify that in the performance of the, work for which this permit is issued, I shall not
employ any persorty n in amanner so as to become subject to the Workers' Compensation.
Laws of California
Date ' Owner
NOTICE TO APPLICANT: if, after making this Certifwate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this Penmf shall be deemed revoked.
i
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
Lenders 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 certify that I have read this application and state that the above information is correct.
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.
i
Signature of applicant Date'
Mailing Address
City, State, Zip
1
f
Sq. Ft. 1052 No. No. Dw.
Size M• Stories -Units
New ® Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $104,1.39.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
'544.73
Const.
557.8 ;
Mech.60.00
Electrical
`F w ° 113.36
Plumbing.
126.50
S.M.I.
7.35.
Grading
Driveway Enc.
Infrastructure
2.; •
tvinge-toed
131.06,
TOTAL
xj L�";+: !
REMARKSftti=lG-Lit
4i�f>+1'/--xf• �?91 r: <'�,i.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 5114/89Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE o
2ND FL Sp. FT.
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. gp, FT, ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. SQ. FT. ®
TEMP. POLE
WALL Sp. FT.
GROUT
DRINKING FOUNTAIN.
SO: FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_$
FLOOR DRAIN
MECHANICAL FEES
FRAMING
G (
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
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, 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.
SO. FT. RESID ® 1 Ve c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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 o
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING,
DUCT WORK
ROCK STORAGE
//
FOUND. REINF. �j�
GAS (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.
FRAMING
G (
FINAL INSP. I.
ROOFING
�'
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING f—OfV/_ `O*X—eL—
MESH
INSULATIONISOUND Q
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
'
GARDEN WALL FINAL