The URL can be used to link to this page

04777 (ELEC)04777 , P.O. BOX 1504 BuildinAddrress Inverk ass LA QUINTACCALIFORNIA 92253 Owner - aSuhriaE3 Df3sart Partn&*n —.. BUILDING: -TYPE CONST. OCC..GRP. Mailing Address 75-005 COUntry C`,lUb A.P. Number . IPG West Phase 26B City Zip Tel. Palm Dese�r� 92260 568.2828. Legal Description Contractor Project Description 100 amp common area meter National Mortgage Address k .. J __ •City - Zip Tel. State Lic. City & Classif. Lic. # Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units .Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address, Tel. City Zip State Lic. # r' LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70pp) of Division 3 of the Business and Professions Code, and my license is in full force and _SIGNATURE DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following —0— reason:. (Sec. 7031.5,Business 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 AMOUNT requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT - the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/ 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 (5500). Plan Chk• Bal. O 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 Const. 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, Mech. provided improves 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 Electrical 0 Z)v of proving that he did not build or improve for the purpose of sale.) _ 0 I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project'(Sec. 7044, Business and Professions Code: The Contractor's License Law - does notapply to an owner of property who builds or improves thereon, and who contracts for S.M,I. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading O I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date Owner f Infrastructure k 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. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS ti f f 10 31 Hi :t 4 _`(ul--tits WORKERS' COMPENSATION INSURANCE ��# ,f WI l�f, Q (This section need not be completed if the permit is for one hundred dollars ($100) valuation I or less.) I certify that in the performance of lhp work for which this permit is issued, 1 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: 9, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwithMinimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. Front Setback from Center Line 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, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR This is a building permit when properly filled out, signed and validated, and Is subject to ��R expiration if work thereunder is suspended for 180 days. 1 certify that I have read this application and state that the above information is correct. Issued by: Date Permit 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. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip WHITE FINANCE PINK APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO F1 (p S UNITS SLAB GRADE ROUGH PLUMB BONDING YARD SPKLR SYSTEM 2ND FL SO FT. g FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC BAR SINK POR SO FTgr GAS (ROUGH) METER LOOP GAR SO. FT. Cr I IPOWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CARP. SO FT. 6 GROUT WATER HEATER WALL SO FT. @ FINAL INSP. DRINKING FOUNTAIN SO. FT. a WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION S =$ WATER PIPING NOTE* Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHERIAUTOXDISHI APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 1KITCHEN 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 LATHING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID g 11A c SEWAGE DISPOSAL SO.FT.GAR (g 3/.c HOUSE SEWER FINISH GRADING 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 8 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 APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. j -Plus-x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL