13984 (PAT)4Q
t , P.O. BOX 1504
Building 44--345 Villeta Dr 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Jim blartlia Cathcart
Mailing
Address 44-345 Vilieta Dr
City Zip Tel.
La Qulrta 92253 345-6461
Contractor
Self -
Address
Sam
City izip Tela
State Lia _ I City
& Classif. Lic. #
Arch:; Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED. CONTRACTOR'S DECLARATION
I hereby affirm that ram licensed under provisions of Chapter 9 (commencing with Section
70 OO) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busfness and Professions Code: Any city or county which requires a
permit to construct, alter, fmprove, 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
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Codefor that. he is exempt therefrom, and the bas'
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not morefthan five hundred dollars ($500).
0 I, as owner of the property, or my employ-ees 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 Contractor's License Law does not apply to an owner of property who
builds or improves thereon and whc�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 improve. for "the purpose of sale.)
. O I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and'Pq?fessions 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:pursuanl to the Contractor's License Law.)
O 1 am exempt under Sec. B.'&P.C. for this reason
Date
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.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you .must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a'building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. • 13984
BUILDING: TYPE CONST. 1 a OCC: GRP.
A.P. Number 604174016
Legal Description Lo 13$ TR # .23269
Project Description Rear Patio Cover
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
., 411
Side Setback from Property Line
FINAL DATEINSPE N -'-
E; -
Issued by: Date Perml 7 099
Validated by: t
Validation: 1 i
rte
Sq. Ft. 300 No.
Size Stories
No. Dw.
Units
New OX Add ❑ Alter O
Repair ❑ Demolition O
Estimated Valuation $4001.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
46..80
Const.
72..00
Mech.
Electrical
Plumbing
S.M.I. -
.50
Grading
Driveway Enc.
Infrastructure
TOTAL
s
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
., 411
Side Setback from Property Line
FINAL DATEINSPE N -'-
E; -
Issued by: Date Perml 7 099
Validated by: t
Validation: 1 i
rte
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
r '
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SD. FT. ®
SEWER OR SEPTIC TANK
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
GAS (ROUGH)
METER LOOP
DRAINAGE PIPING
CAR P. SQ. FT. ®
REINF. STEEL
I
GAS (FINAL)
DRINKING FOUNTAIN
WALL SO. FT. ®
GROUT
WATER HEATER
URINAL
SQ FT ®
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
J
n
11''AA
l U` 10
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 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
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 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 !
l'
FINAL INSP.
ROOFING
J
n
11''AA
l U` 10
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL