003053 (BLCK)TAiyl
44
Z�dGv
P.O. BOX 1504 No. 0030553
Building78-105 CALLE ESTADO
Address Si- 50 LA QUINTA, CALIFORNIA 92253
Owner ARMUSTER
Mailing I
Address MW 52-340 CARRARZA
City Zip Tel.
LA. -Q€ IMA 92253 564-2043 '
Contractor
OBER BUDS.
Address. .
SAM AS AWVB
City lZip Tela
BUILDING: TYPE CONST. • OCC: GRP.
A.P. Number 773-152-006
Legal Description
Project Description RETA INN `WAI L. 3' HIGR
State Lic.
City
& Classif.
Lic. #
Sq. Ft.
Size} • Pmt'..
No. No. Dw.
Stories, Units
Arch., Engr.; "
New MX Add ❑
Alter-❑' • Repair ❑ Demolition ❑
Designer
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
7000) 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,Business and. Professions Code: Any city or county which requires: a
permit to construct, alter, improve, demolish, or repair any structure, prion 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 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
-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 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' or properly,who
builds-oi 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 ..;.
or Improvement is sold within one year of completion, the owner -builder will have the burden
or proving that he did not build or Improve for the purpose of sale.)
Estimated Valuation
PERMIT •
' '" AMOUNT
Plan Chk:.Dep.
Plan Chk.' Bal.
14,3%
:COrISt.:
�-
- - 22..00
Mech'.
'
"Electrical
'
Plumbing
.D I, as owner of the property, am exclusively contracting with licensed contractors to con-
. •slruct the project. (Sec. 7044, -Business and Professions Code: The Contractor's License Law
- does not apply to an owner of property who builds orimproves thereon, and who contracts for
such projects with a contractors) licensed pursuant to the Contractor's License Law.) ••
.. . ❑.I am exempt under Sec: B. 8 P.C. for this reason
S. M.I.
.._
r�}'}
Grading
,
Driveway Enc.
`/
"Date t! �-��IG ?Owner .�'• .��
Infrastructure
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. O Certified copy is hereby furnished.
TOTAL
3«�,
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(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.
ZONE: BY: '
Minimum Setback Distances: - '
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
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 Street Setback, from Center Line
Side Setback from Property Line
Lender's .Name
Lender's Address
FINAL.DATE
Issued by: -.Date
Validated by:
INSPECTOR
4114187Permit
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
Validation:
B7749
4 14 368b TI
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES 1
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. FT, ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS )f'k
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1114 c
SEWAGE DISPOSAL
DE.0 17 4987
SO.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
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 )f'k
SEWER OR SEPTIC TANK
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
DE.0 17 4987
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPEUI UR'5 51UNA1 UHL511NI I IALS
GARDEN WALL FINAL