13486 (MECH)13486 , ,(
P.O. BOX 1504 No. ' ••
Building --49-931 AV ViStA Bonita, 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
'William, int.' Leigh
Marlin 9 BUILDING: TYPE CONST.t OCC'. GRP.
Address F same
' A.P. Number
City Zip Tel. >.
Le Quin.ta, CA 92253 564p.9194. Legal Description ^t.
Contractor lh5tall'" 40 gal. natural
Valle Plumbing Project Description
"... i02C `
gas cater heater.
665
Cit Zip ' Tel:: "
�d,o. C,' - 92202 3i7-3629
State Lic _ City <�
& Classrf 21Q8$- �3$ Lic. # JiQi Sq. Ft. T No °, '' No. Dw.
Size - `.; Stories Units+:
Designer New ❑ Add ❑ ' -Alter "p Repair ❑ Demolition ❑• _
Address Tel. _•{
City Zip State
Lic. #
LICENSED CONTRACTOR'S. DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section + f
000) of Division 3 of the Businessland Professions Code, and my license is in ful ,force and
effect
•GNATURE DATE -
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation $.4320' 00
w t>
reason: (Sec. 7031.5,Business and -Professions Code: Any city ortcounty which requ:ies a
permit to
construct, alter,•Improve, 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 . " PERMIT AMOUNT
{
the provisions of the 'Contractor's License'_ Law,. Chapter 9, (commencing with Section 7000) of I -
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 permit Plan Chk.- Dep. -
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). -
❑ I, as owner of the property, or my employees with wages as teir sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and CpnSt�.1!}�
Profes.
ions Code: The 'Contractor's License Law does not apply to an owner of property who -
builds 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 Mech. _
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical- y '
of proving that he did not build or improve for the purpose of sale.)
p I, as owner of the property, am exclusively contracting with licensed contractors to con-•- Plumbing 7.50
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's. License Law
does not apply to an owner ofpropertywho builds or improves thereon, and who contra:ts for :S, M. 1.
• such projects with a-contractor(s) licensed pursuantto the. Contractor's License Law.)-
O 1 am exempt under Sec. B. & P.C. for this reason Grading
t "Driveway Enc.
Date owner ' fi %Infrastructure ,
t/
.!.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 r
pfCopy'fs filed with the city.. ❑ Certified copy is hereby furnished. f
TOTAL 7.2. 50
CERTIFICATE OF EXEMPTION FROM REMARKS <
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pemrit is for one hundred dollars ($100) valuation
or less.) ' • , ,
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: If, Iter making
this Certificate of Exemption your should become .,ZONE: - BY:' _ • -
subject to 'the Workers' Compensation provisions of the .Labor Code, you must' forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. + - '
Front Setback,from Center Line
< 4 Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is'a construction lending agency for the performance of the +
work for which this permit is"issued. (Sec. 3097,.Civu Code.) --Side Setback from Property Line -
Lender's Name" -�
Lender's Address N FINAL DATE INSPEG OF
This is a building permit when properly filled out, signed and validated, and is subjectto
expiration it work thereunder is suspended for 180 days. ''� J I ►
I certify that I have read this application'and state that the above information is correct. Issued b F Date Perml u 1 "
I agree to comply with all"city and county ordinances and state laws relating to building y'. _
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes. Validated by: �I c'"ii Y I P(}
Signature of applicant Date
Mailing Address Validation: I p„ " t �{ ? '✓/(
City, State, Zip _
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
I
SEWER OR SEPTIC TANK I ROUGH WIRING
MOBILEHOME SVC
BAR SINK
FOR. SO. FT. ®
GAS (ROUGH) . METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEATER SERVICE
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING '
NOTE: Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES.
— -
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a 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 PLUMBING UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
I
SEWER OR SEPTIC TANK I ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
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.
FINAL INSP.
FRAMING
FINAL INSP. +
ROOFING
d ,
(j
J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL