003851 (BLCK)Building 51-870 Morales'
Address
Owner
Roni Armbruster
Address
City
Zip Tel:
.. -
7—gi,
Contractor
. 12 Iaf--- r
.Address
City lZip ITel...
State Lic.
City
& Classif: Lic. #
Arch., Engr.,
Designer
tU'�t,�cu
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 003851
BUILDING: ,-TYPE CONST. - . OCC: GRP.,
A.P. Number 7 -11 -2r.2-13117f
Legal Description
Project Description 9 it -TAI 7t
Sq. Ft.' No. No. Dw.
Size -.-Stories Units
New 0 Add 0 Alter El: Repair 0. Demolition ❑
Address
Tel.
C ity
State
. ]Zip
Lic. #
77--7-
LICENSE - D CONTRACTOR'S DECLARATION
.l hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section -
�0 of Division 3
130) of the Business and Professions Code, and my license is in full force and -
effect...
_SIGNATURE DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License'Law for the following
$750
reason: (,Sec. 7031.5,Business and. Professions Code: Any city. or county which, -requires a
.00'
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
DIVislon 3 of the Business and Professions Code, or that `he is exempt therefrom, and the' basis
• for. the alleged exemption. Any Section 7031.5 by 'any for
Pla -Chk..bep'.
violation of applicant a permit.
'subjects the applicant to a civil penalty ofnol more than five'hundred dollars ($500). *
. Plan Chic. Bal..
0 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 f6i sale.' (Sec: 7044; Buisness and
W -
Professions Code: The Contractor's License Law does not apply:to -an owner of,prope y who
1 .9. rt . �
. .,Const.
(11 firk
,
builds or impro�6s 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..bullding..
or Improvement is sold within one year of completion,. the owner -builder will have the burden
Electrical
of prqving that he did not build or improve for the purpose of sale.)
0 1, 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 ' not apply to an.owner of property who builds or improves thereon, and who contracts for
S.M.I.-
such projects with a contractors) licensed pursuant to the. Contractor's License Lam)
Grading
C1 I am exempt under.Sec. B. & P.C. for thisreason
Driveway Enc.
Date ,"xxowner 1—
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. 3806, Labor Code.)
Policy No'' . Company
O. Copy is filed with the city, 0 Certified copy is hereby. furnished. -
TOTAL
CERTIFICATE OF EXEMPTION FROM f
REMARKS
WORKERS' COMPENSATION INSURANCE
(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 thp work for which this permit is issued, I shall not
employ any
Laws of California.n in any manner so as to become'subject to the Workers' Compensation
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: X" U%;o QQ i� 0
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from CenterLihe.
Ihereby 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.DATIE
INSPECTOR
This is'a building permit when properly filled out; signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
At I S/ApPermit
I certify that I have read this application -and state -that the aboveAnformation is correct:
'and
Issued by:
Date
I agree to cornply'with all citycounty ordinances and state laws relating to building
construction, and hereby authorize representatives -.of this city to enter the 'above-.
m . entioned pro . perty for inspection purposes.
Validated by:
Signature of applicant —Date—
Mailing Address
Validation:
City, State, Zip'
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ, FT, ®
CARP. I SQ. FT.
WALL SQ. FT. ®
SQ. 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
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER 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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL