05487 (SFD)P.O. BOX 1504 No05487"
Building 48-143 Vista Cialo 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
! Abe & c:l $
Mailing BUILDING: TYPE CONST. OCQP?1GRP.
Address
flQ CoxbiaAve. s.'! A.P. Number 619-640-'036
City Zip Tel.
' Northridge 91334 818/349--5894 Legal Description Lot 36
Contractor Project Description ��
Jame C. Caste
Address
4 77-200 Mmesota
City Zip Tel.:
60/345-54
92260 4;L30
State LIc City
& Classlf " B 195333 Lic. # 260 Sq. Ft.. No. No. Dw.
A ...1. .L.....
Size "" Stories Units
Designer
Address- . Tel.
j
City JZip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
II 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
SIGNATURE DATE
I OWNER -BUILDER DECLARATION
i' 1 hereby affirm that 1 am exempt from the Contractors LicenseLaw for the following .
reasOm (Sec.- 7031-5,13usiness and Professions Code: Any city or county which requires a
permft to to'sbuct' after, improve, demolish, or repair any structure, prior to its issuance also
regrrtres Uwe appfcad for such permit to file a signed statement that he is licensed pursuant to
Me provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Gvision 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exertption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the appilranf to a civilpenally 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
Rofessbrs Code: The C mbactor's License Law does not apply to an owner of property who
bultds 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 yea of completion, the owner -builder will have the burden
of proving that he did not bull orxnprove for the purpose of sale.)
011, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the projecL (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.)
f
❑ 1 am exempt under Sec B. & P.C. for this reason h
t
Bate Owner
1WORKERS' COMPENSATION DECLARATION
i 1 hereby affirm that 1 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
0 Copy is filed with the city. ❑ Certified copy is hereby furnished. .
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed ff the permit is for one hundred dollars (8100) valuation
or less.)
1 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
Dote Owner
- N077CE TO • APPLICANT: B, after, making ' this Certificate of Exemption you should become
subject to the Wbrdcers' Compensation provisions of the Labor Code, you must forthwith
Coney with such pwdsiois or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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
Lenders Address
jThis is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that 1 have read this application and state that the above information is correct.
1 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 Add
City, State, Zip
New Cl Add ❑ Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation $102,226.00
"PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal..a3
Const.
Mech.
642'4U0
Electrical
11.1,72
Plumbing
144450-
S.M.I.
7.21
Grading
Driveway Enc.
Infrastructure
Vis'
Fr JJWe—t4Ded
13 1 1.0b
-----------------
TOTAL
REMARKSie
- d.`{l�•ry"t � f�.r •l �� � t'i'�..�"f f'��: �. t i t'i-i3> .r .
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 3/14/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE �'
OUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. @
(ROUGH)
Le ETER LOOP
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. @
GROUT
WATER HEATER
WALL SO. FT. @
FINAL INSP.
DRINKING FOUNTAIN.
FT @
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFING j y
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 9Uf
MESH
INSULATIONISOUND �1 v
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
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
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.
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 @ 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 PLUMBINGUNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �'
OUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
`
FOUND. REINF.
yy �'
(ROUGH)
Le ETER 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 i l FINAL INSP.
ROOFING j y
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 9Uf
MESH
INSULATIONISOUND �1 v
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
-
REMARKS:
SIGNATURESIINITIALS
GARDEN WALL FINAL