COMB (11356)Building '51-592 Navarro
Address
Owner
Conrad Santiago
Mailing"
Address p. 0. Box 54
City Zip
La Qui nta 92253
Contractor
0W_r1,6 /BUi1der
Address
P.O. BOX 1504 No. 11356 _ { /'ti' � • '
78-105 CALLE ESTADO
LA QUINTA,'CALIFORNIA 92253 a "
_ BUILDING: TYPE CONST.: OCC: GRP.
A.P. Number 77 - � }4� ;$�, i t} � f l.t` 9 ^00 _J4
Tel.
. 56.4-•4569 • Legal Description Lot 21 '. jB.fo..-k 110
Project Description • Combination carport E,
_ storage 'zooPn,i w/- a connecting trellis
r r t
City
Zip .
Tel.:
Building '51-592 Navarro
Address
Owner
Conrad Santiago
Mailing"
Address p. 0. Box 54
City Zip
La Qui nta 92253
Contractor
0W_r1,6 /BUi1der
Address
P.O. BOX 1504 No. 11356 _ { /'ti' � • '
78-105 CALLE ESTADO
LA QUINTA,'CALIFORNIA 92253 a "
_ BUILDING: TYPE CONST.: OCC: GRP.
A.P. Number 77 - � }4� ;$�, i t} � f l.t` 9 ^00 _J4
Tel.
. 56.4-•4569 • Legal Description Lot 21 '. jB.fo..-k 110
Project Description • Combination carport E,
_ storage 'zooPn,i w/- a connecting trellis
City
Zip .
Tel.:
State Lic:
City
& Classif.
`
Lic. #
Sq. Ft.._ •75 2• c •
. • iJo No. Dw.
Arch:, Engr.;
Size
:- Stories ' :Units .-
Designer C6-arad Santiago-; Architect
New ❑ Add •❑
'- Alter El Repair ❑ Demolition ❑
Address
TeL
r., P.. 0.'. Box 1314,,.,o
564--7430
City�.`
Zip
State
,
La' Quin . ':
92253
Lic. # C2115
.. -
` LICENSED CONTRACTOR'S DECLARATION -
1 hereby affirm. that I am licensed under provisions of Chapter 9 (commencing with Section . •
7000) of Division 3 of the Business Professions Code,
-
and and my license is in full force and
effect.
{
SIGNATURE r DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the -following
Estimated Valuation
9 0,001,� 51
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, prior to its issuance also .
.
requires the applicant for such permit to rile a signed statement that he Is licensed pursuant to.
• PERMIT;
.: f`• - -
-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. heis exempt therefrom, and the basis
,for the alleged exemption. Any violation of.Section 7031.5 by,'any` applicant for a peimit
-
~ Plan Chk. Dep.
- •
' 'subjects the applicant to a civil penalty of not more than five hundred dollars ($500). . 1-
• [ill, as owner of the property, or my employees with wages as their sole compensation,'will
Plan Chk- Bal.
- 81.90
do the work, and the structure is not intended or offered for sale. (Sec.- 7044, Buisness'and
Professions
Const.
" 6 . 00'.
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,
provided II.esuch Improvements. are not intended or offered for sale. If, however, -the building
Mech.•
-
-
";-•.or. improvement is.sold within one year,of completion, the owner -builder will have the burden
Electrical
•�';rr • '
of proving that he did not build or improve for the purpose of sale.)
-
` O 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 improvesthereon, and who contracts for
- S.M.I. •
1
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -.
Grading
- _
❑ 1 am exempt under Sec.•• B. & P.C. for this reasons
Driveway Enc. "
` Date owner^> '✓ �' .sv� FrsJ1.�� adC.
.,r
Infrastructure
z '`
WORKERS' COMPENSATION DECLARATION
l .
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
'
7
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) -
- • ' e '
'
Policy No. • .Company
a •• . w.�,
,
'
❑ Co is filed with the cit 0 Certified co
Copy y. copy is. furnished.
TOTAL
t209.00 -
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section, need not be completed Uthe permit is for one hundred dollars (5100) valuation
-
- or less.) - . I . _
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 toothe Workers' Compensation
Laws of California. i• jj
Date Owner`
NOTICE TO APPLICANT: It, after, making this Certificate -of Exemption? you should, become
ZONE:
•Distances:
BY: -•'' • •"
' subject to the Workers' Compensation provisions or the Labor. Code,/you must forthwith
comply with such provisions or this permit shall be deemed revoked. •y
Minirllum Setback - -
„
Front Setback from Center Line '
Rear Setback from Rear Prop. Line`
' CONSTRUCTION LENDING AGENCY - -
Side Street Setback.from Center Line
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 Setback from Property Line
Lender's Name
-
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to .'
FINAL DATE
INSPECTOR
expiration if work thereunder is suspended for 180 days.
_ ., I
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 building
• construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes.
Validated by: -
Signature of applicant - -Date-
ateMailing
MailingAddress
Validation:
City, State, Zip
a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND F.L. SQ. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
BOND BEAM
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEEPLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
in 0
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. U
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.
/
/ v�
FRAMING1 l� 6
FINAIL INSP.
//
ROOFING
Ll�3�
�}��fa
/
CO VA �vlD(v�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION -,5/17/1 3 Lp
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL