05519 (SFD)Building 48-130 Vista Cielo
T4#`�v 4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
(
Abe 6 TUelmn Grossman
Mailing
Address
9010 CorbIA Ave. 8.3
Sq. Ft. 1�gi
Size
City
1 Northrl4ge
Zip
91324
fTel.
818/349-5894
Contractor
Jazies C. Cashman
Address
'
77-200 Hinnesota
$82,143.1.00
Cil P1i x
Desert
Zip 92260
T91,9/345-5430
State Lic.
City
& Classif.
$ 195333
Lia # 260
Electrical
Plumbing
Arch., Engr.,
S.M.I.
Designer
Driveway Enc.
Address Tel.
City Zip 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 forrcce'and
effect.
./� SIGNATURE ..�' ,/ DATE
I OWNEWBUILDER DECLARATION
Il. hereby affirm that I am exempt from the Contractor's License Law for the following
reasoh Sec. 7031.5.Bsiness and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, .prior to its issuance .also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Conbactor's License Law, Chapter 9 (commencing with Section 7000) of
0lvisbn 3 of the business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a tan? penalty of not more than rive 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 Contractors License Law does not apply to an owner or property who
ba7ds or. irproves thereon ad 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
orimprovement is sold within one year or completion, the owner -builder will have the burden
of provhV that he did not build or'reprove for the purpose of safe.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
vstruct 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
sucA projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
❑ 1 am exempt under Sec B. 8 P.C. for this reason
Date: Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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
�.I/Copy is filed with the city. ❑ Certified copy is hereby furnished. m
CERTIFICATE OF EXEMPTION FROM ( m
i WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
Or less.)
1 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: 8, after making this Certificate of Exemption you should become
subject to U16 Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
j
CONSTRUCTION LENDING AGENCY
li 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.) '
Lend'er's Name
Lenders Address
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity 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'
No. 05519
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 61.7-64ID-067
Legal Description to -t67
Project Description Plan
No. Dw.
Units
Repair ❑ -Demolition p
4
)
AMOUNT
4471.92
563.00
60.00
•96.97
120.50
5.81
1,848.24
e f1
REMARKS
- pyj"'r' t',)r1, rr: Y t....�'�' �t�•�n� xTf
_ ti:T.,�?3�£O.M+ro�i� fs Y.1�'�7,'�ir•..P y"7•)!'.i'Y �•F:
ZONE: I 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
ATEINSPECTOR•Issued by: Date/14/89 Permit
Validated by:
Mailing Address Validation:
City, State, Zip
Sq. Ft. 1�gi
Size
No.
Stories.
New O Add ❑
Alter ❑
Estimated Valuation
$82,143.1.00
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Prime --tom
TOTAL
No. Dw.
Units
Repair ❑ -Demolition p
4
)
AMOUNT
4471.92
563.00
60.00
•96.97
120.50
5.81
1,848.24
e f1
REMARKS
- pyj"'r' t',)r1, rr: Y t....�'�' �t�•�n� xTf
_ ti:T.,�?3�£O.M+ro�i� fs Y.1�'�7,'�ir•..P y"7•)!'.i'Y �•F:
ZONE: I 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
ATEINSPECTOR•Issued by: Date/14/89 Permit
Validated by:
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL, AREA
SLAB GRADE jgZ
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
SVC.
BAR SINK
POR. SO. FT. @MOBILEHOME
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CARP. SO. FT.
GAS (FINAL) TEMP. POLE
WALL SO. FT. ®
DRINKING FOUNTAIN.
SO FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
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
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 PLUMBI4 ELECTRICAL HEATING & AIR COND. SOLAR
v�4sa.
SETBACK
GROUND PLUMBING UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE jgZ
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF. S A3
s J
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.
INAL INSP.
FRAMING 7/ �'
FINAL INSP.
01
ROOFING
/ L/� /q/
j� f^^ ^ / (� ((( (( ((%% 49 /�i/f / ';
Dc
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING (0
MESH
INSULATIONISOUND 47 e B
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
t