BLCK (14778)Building
Address 81--935 Mwu ntai View
Owner
JCC Homes
Mailing
Address 3480 Torrence Blvd.
CityrZip Tel.
.Torance,
Contractor
Hamilton Masonry
Address
P.O. Box 1771
C't Z' T 1`
4
P.O. BOX 1504
78-495 CALLE TAMPICO
LA OUINTA, CALIFORNIA 92253
3a ► --Uinta, CAS I'p 92253 e..345'--7"653."
State Lic. City
& Classif. C29 591684 Lic. # 1631
No. 14778 -
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description
550-1- of -61 digs garden
block. wax i in rear . yard .
CERTIFICATE OF EXEMPTION. FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars (8400) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
-employ anyperson 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. -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, -AND
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;
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND
ATTORNEY'S FEES.
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
City, State, Zip
REMARKS
q.
Size
o. No. UW.
Stories Units
Arch., Engr., . ...
BY; ~
Minimum Setback Distances:.
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ -Demolition ❑
Address
Tel.
�
Side S et Setb \, • om enter Line
Side.S/etback from Prope y Line� '
eINSREGTOF
FINAL DATE
City
Zip
State
Validated by:
Lic. #
Validation:
LICENSED CONWCTOR'S DECLARATION
I hereb refit that aP""m lioe ted u�d�r rovisions of Chapter 9 (commencing' with Section
7000) of iv's'o 3 of'th_e_Blus�'ness P fessions Code,
an and my license is in full force and
effe �S h1
"" tI V,7
-•„
81GNA URE' - - DATE
'
OWNER -BUILDER DECLARATION
Estimated Valuation
1 hereby affirm that I am exempt from the Contractor's License Law for the following
�SvA •.0
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, prior to- its issuance also
-'
requires the applicant for such permit to files signed statement that he is licensed pursuant to
'. PERMIT
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
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.
-
❑ 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.
�Q
Professions 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 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
'reprove
Electrical
of proving that he did not build or for the purpose of sale.) . _
❑ 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 not apply to an owner of property who builds or Improves thereon, and who contracts for.
S.M.I.
such projects with a contractors) #.censed pursuant to the Contractor's License Law.) .
Grading
❑ I am exempt under Sec B. 8 P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure; or a certificate of
Worker's pensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy .Company
- Copy Is filed with the city, . ❑ Certified copy is hereby furnished. .
TOTAL.i3.
(}f3
CERTIFICATE OF EXEMPTION. FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars (8400) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
-employ anyperson 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. -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, -AND
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;
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND
ATTORNEY'S FEES.
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
City, State, Zip
REMARKS
ZONE:
BY; ~
Minimum Setback Distances:.
Front Setback from Center Line
Rear Setback from Rear Prop. Line `
�
Side S et Setb \, • om enter Line
Side.S/etback from Prope y Line� '
eINSREGTOF
FINAL DATE
_ 1
? red iPe�it
Issued by: •
Date
6 y/
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINu FEES
IST FL. SO. FT. ® $
2N0 FL. S0. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. S0. 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
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.
SO. FT. RESID ® 1Ya c
SEWAGE DISPOSAL
SO.FT.GAR ® 34c
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE •
CONST. FEE1 ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR CON D. 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
INSULATION/SOUND
FINISH GRADING
OrA—NAL INSPECT10
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESlINITIALS
GARDEN WALL FINAL