AR (14678)• I
\` 6y\ 5/,(APDV,15 P.O. BOX 1504
Building 78-495 CALLE TAMPICO
—240 Fox Run LA
Address QUINTA, CALIFORNIA 92253
Owner mAnistrelli Development
Mailing 54-445 Mountain ShadowAddress _-
City Zip Tel.
La. Quinta; CA 92253 564 -1849
Contractor
Address
No. 14678.
BUILDING: TYPE CONST. ` " OCC. GRP. i
A.P. Number 769-550-044
Legal Description Lot 48 Tract 25429
Project Description" Sup* plemcil tal g@riYl '1` to
Permit 01-450.3 for -addition of 81 s. f.
t® dwelling
City
Zip
Tel.:
State Lic. 5938:99
City
& Classif.
Lic. #
Sq. Ft. No. No. Dw.
Size 81 . • Stories Units
Arch., Engr., -- -
Designer
New ❑ Add ❑ :. Alter ❑ Repair ❑ Demolition p
Address
Tel.
,� City
Zip
State
Lic. #
. LICENSED CONTRACTOR'S DECLARATION.
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000 of Division 3 o tfie Business and.Professidhs Code, and m license is in full force and '
Y
effect•' "
SIGNATURE DATE
-
OWNER -BUILDER DECLARATION -
1 hereby that I from the Contractor's License Law for following
EStlmated .] a9 n
Valuation -$4 98.00
affirm am exempt the
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
/ .
permit to construct, after, Improve, demolish, or repair any structure, priorto its issuance. also
• requires the applicant for such permit to rile 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
"
-
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 rive hundred dollars ($500). -
Plan Chk. Bal. 46.80
❑ I, as owner of the property, or my employees with wages as their sole compensation, will.
do the work, and the structure is not intended or offered for sale: (Sec, 7044; Buisness and
_
Const. �V
Professions Code: The Contractor's License Law does not apply to an owner of property who
G
I . it
builds or improves thereon and who does such work himself or through his own employees,
Mech. ' ". ��
.provided that such improvements are.not intended or offered for sale. If,.however, the building
or improvement is sold within one year of completion, the owner -builder will have the .burden
Electrical$�
of proving that he did not build or improve for the purpose of sale.) -
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing 80
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. A4
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading 00 .
❑ I am exempt under Sec B. & P.C. for this reason
,
Driveway Eric. 00
Date Owner
Infrastructure 98.36
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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 a`r Company
Copy is filed with the.city.. ❑ Certified copy is hereby furnished.
TOTAL 221.04
CERTIFICATE OF EXEMPTION -FROM
REMARKS
WORKERS' COMPENSATION INSURANCE,
(This section need not be completed if the permit is for one hundred dollars' ($100) valuation
' or'less.) '
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to'become subject to the Workers' Compensation.
Laws of California
Date Owner
-
NOTICE TO APPLICANT: N, alter makkmg this Certificate of Exemption you. Should become
ZONE: - BY:
subject to the Workers' Compensation provisions of the Labor 'Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
_ - - / -
Minimum Setback Distance$: /i1
Front Setback from -Center L1ne
♦'IF//
Rear Setback from Rear Prop. -Line
WARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
r�
er Center in
Side Street SetbackL e f '
SHALL Sl1BJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
- 41,ofrom >+
V
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 LABOR CODE; INTEREST, AND
ATTORNEY'S FEES.
�L
O ��
FINAL DATE INSPECTOR •t!
This is a building permit when properly filled out, signed and validated, and is subject to
NX J
expiration if work thereunder is suspended for 180 days.
`19^
I 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—
ate
Mailing
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIWU FEES
1ST FL. SQ. FT. ® $
2ND FL. SO. FT.
FOR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I SO. FT.
WALL SQ. 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
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(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.
SQ. FT. RESID ® 11A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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 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
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL