15765 (AR)A;
£, P.O. BOX 1504 N o .
Building 78-495 CALLE TAMPICO
Address . 56a;086 Pebble Beach- LA OUINTA, CALIFORNIA 92253 '
Owner.. P. Byrne Texihorst r
f
Mailing BUILDING: TYPE CONST. • OCC: GRP.
•
Address Same A.P. _Number
City Zip Tel.
La, QuiY3ta,53 Legal-Description
Contractor,`Eaft1°ose Atrium
um `
Cal Tech Bi2ilders � ... Project Description `
Address
52-711 Ave., Rubio -
City Zi Tel.:
L,a Qt i ta, CA 112&
564-1309
State Lic. City
& Classif. ,' , n 590090 Lic. # 402 Sq. Ft. ter. N6.- No. Dw.
Arch., Engr.,
Size ,+_=94 Stories Units
Designer Paul'. scotAnderson AIA. New ❑ Add ❑ ': Alter ❑ Repair ❑ iDemolition'❑
... VddCr`3e.s Boit` 177 TeI'564- 503
city
La QZDZ4- t 6" Zip 9225: Lic.t#
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section } 1 ? u:i
7000) of. Division 3 of the Business and Professions Code, and my license is in full force and :4
effect.
3LGNATURE - DATE-
OWNEWBUILDERDECLARATION Estimated Valuation P` f�7 prt
I hereby affirm that I am exempt from the Contractor's License Law for the following' , • ,? '� J p; 1. . Vti ;
reason: (Sec. 7031.5,Business and,Prolessions Code: Any city or-county which requires a - -;
permit to construct, after, improve, demolish, or repair any structure, prior to Its issuance also
. , requires the applicant for such permit to file a signed statement that heis licensed pursuant'to • P PERMIT• ' AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of E`' ` - *�'" '
Division Sof of
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: , S
subjects the applicant to a civil penalty of not more than five hundred dollars (S500). -- -
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.* aQ a %(pi
do the work; and the structure is not intended or offered for sale. (Sec. 7044, Suisness and Const. _10� flE)
Professions Code: Th e Contractor's License Law does.not apply to-an owner of property who i - "'�
builds or Improves thereon and who does such work himself or through his own employees, Mech.
provided that'such Improvements are not Intended or offered for sale. If, however, the building-
or
aJ ii `
or improvement-is .sold within one year of completion, the owner-builder will have the burden Electrical
of proving that he did not build or knprove for the purpose of sale.) •
❑ I, as ownet of the property, am exclusively contracting with licensed contractors to.con- Plumbing. l 'e`Q0. '
strucl the project. (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 S,M.I- - - �1
such projects with contractors) licensed pursuant to the Contractor's License Law.),
❑ I am exempt under Sec.Grading
- B. & P.C. for this reason
Driveway Enc.
DateOwner Infrastructure
r f.
WORKERS' COMPENSATION DECLARATION i
I hereby affirin 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.. 23 9.5 5
CERTIFICATE OF EXEMPTION WORKERS' COMPENSA ON NSURA CE REMARKS `' ,; -�, j f�
(This section need not be completed if the permit is for one hundred dollars (S 100).- valuation. - --••�. %
.. or less.)-
1 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, after making this Certificate of Exemption you. should become ZONE: BY: ' - -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith - - -
comply with such provisions or this permit shall be deemed revoked. - Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND - Side Street Setback from Center Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS.($100,000), IN ADDITION TO THE COST OF. COMPENSATION; .. Side Setback from Property Line'
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABORCODE, INTEREST; AND '
ATTORNEY'S FEES.,
-This Is abuildin FINAL ES - •1 INSPECTOR
g-permit when property filled out, signed and validated, and is,subjectto'
expiration it work the' :4 „ _
reunderis suspended for 180 days.
I certify that I have read this application and state that the above information is, correct:,.•ISSUed'by. ' " Date Permit
I agree to comply with all city and county ordinances and state laws, relating-to.lbuilding . • • ,/ - 11
construction, and hereby authorize representatives .of this city 'to enter the abovem.`
''•
mentioned property for Inspection purposes. - c '�" Val
ldated_.by: -
♦A
Signature of applicant ~NDate
Mailing Address tValidation:
City, State, Zip
r.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APP.IEOUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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.
SO. FT. ® c
BATH TUB
_ SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Y4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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 APP.IEOUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESJINITIALS
GARDEN WALL FINAL