05772 (SFD)Building 78-745 VIUMA DME
Address
Owner
T4tyl 4
P.O. BOX 1504 No.
713105 CALLE ESTADO
LA-QUINTA. CALIFORNIA 92253
TERLI li PACIFIC DESERT DE P
Mailing
Address 74-923 HOVELY #130
City Zi Tel.
� DESENY X2260 340—;=9374
Contractor
TRIAD PACIFIC BUILDERS CORP. .
74-023 ROVEL.Y #136
Zip Tel.:
MM
State Lic.I City
& Classif. ------
_-_`_ Lic. #
Designer
Address
City (Zip( State
Lic. #
LICENISED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
te7006) of Diviston 3 of the,Busines_s--a_ Professions Code, and my license is in°full force and
SIGNATURE DATE
WNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec_ 7031.5,8ushess 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 We a signed statement that he is licensed pursuant to
the provisions of the C inhacit" License Law, Chapter 9 (commencing with Section 7000) of
Ofvision 3 of the Busieess and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any vbharion of Section 7031.5 by 'any applicant for a permit
subjects the wpicad to a cfW penalty 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 an owner of property who
builds or improves: dierson and who does such work himself or through his own employees,
.provided. Orat,such imrovements.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 Mat he did not build or reprove for the purpose of sale.)
❑ 1, 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 riot apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a conbactor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & 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
Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Iabor.Code.)
Policy No ' Company Zell- %le` ��% fid Z-'%
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS '
SLAB GRADE /Za
UGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR, Sp. FT. ®
S (ROUGH) ?O
ETER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SD. FT.
=$
LUMBER GR. FINAL INSP. 3 /v 40
FRAMING /1111,1_147 INAL INSP.
Ole
ROOFING D!Y
VENTILATION t/
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND jZ
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
CC ', c MUM
URINAL
SQ FT ®
REMARKS:
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,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% 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 PLCK.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 /Za
UGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REI F. !�
S (ROUGH) ?O
ETER 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. 3 /v 40
FRAMING /1111,1_147 INAL INSP.
Ole
ROOFING D!Y
VENTILATION t/
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND jZ
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
CC ', c MUM
/ . /Q G%
F7
�'�J/ vL e!!-5�p-
REMARKS:
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL