BLCK (11005)./Building
•51.940 Navarro
Owner
Torres
P.O. BOX 1504, -No., 11005
78-105 CALLE ESTADO
LA QUINTA; CALIFORNIA 92253 Ll
BUILDING' TYPE CONST. OCC GRP �•
Mailing
Address 44-371 Sq. Sundown Crest A.P. Number .773-184-010
City Zip ; Tel. '
F.na Quinta 92253. 360-3337 Legal Description Lot 15 €33acse 121
Contractor -
-A:Oe : Torres
Address
same
Project Description 110' of 61' -block wall
' Tel.:
' t
•i=
State Lic.- �
City
& Classif: B 550498
Lic. # - 1451
Sq. Ft.
No. No. Dw.
•
Arch., Engr.,
Size -• -
Stories Units
Designee ;
New ❑ Add ❑
Alter ❑ . Repair,❑.. Demolition ❑
Address
TeL
'
-City . 7
Zip
State
'
Lic. #
LICENSED CONTRACTOR'S DECLARATION
a I hereby affirm that I am licensed under provisions of Chapter 9 (commencin with Section
'. 7000) of Division 3 of the Business and,Professions Ct1de,.and my license is' full f0.
ce and
effect8 r.
•',
-
i1GNATURE �" - DATE
.i
- •
OWNER -BUILDER DECLARATION
Estimated Valuation
- ,
I hereby affirm that I am exempt from the Contractors License Law for the following ,
�y ry
a 6�'iio�
_ reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a.
1 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 .,„
.
• PERMITa'
- -�'+ AMOUNT
the provisions o/ the CaiVactor's License law, Chapter 9 (commencing with Section 7000) o/
-
- •`a -
Division 3 of the Business and Professions Code, or that. he is exempt therefrom; and the basis,
..for 'any
,�• - - - - "
Plane-Chk 'De•p.,
the alleged exemption. Any violation of Section 7031.5 by applicant•for.a permit
,
subjects the'applicant to a civil penalty of not more than five hundred dollars.(8500). '' + : , •'
-
Plan Chk. Bal:-
- _
O 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 of property' who -_
Const.
< a 1• i
,a _ 63.00-
a
• builds or improves thereon and who does such work himself or.Mrough hisownemployees,.
provided .thaf such improvements are not intended or offered'for,safe. If, however;. the building
Mech.: ..
e
,';. • '�� a.,• _
or Improvement is sold within one year of completion, Me owner -burbler- will have the burden
Electrical -
- •'
of proving that he did not build or irnprove for the purpose of sale-)
i
^
O I, as owner of the property, am exclusively contracting with licensed contractors to con -Plumbing
r"
= 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.,j• -
+ w - - - ' ' - ,• � .
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) • . • •
- .-
Grading
m
. - ❑ 1 am exempt under Sec -a• g p -C: for this reason
Driveway -Enc.
Date Owner _ -
Infrastructure
WORKERS' COMPENSATION DECLARATION
r y
Thereby 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 No. .Company
rp
t
(� s ; (j �'r �i ) —Y2
4RAPP �N 7
Copy is filed with the city. O Certified copy is hereby fumished.
") :�.}'t t , J.•
TOTAL
63.40 fir.
- CERTIFICATE OF EXEMPTION FROM
REMARKS
4 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." If, after making this Certificate of Exemption you should become
'
ZONE:_-_'
�-
BY:
subject to the. Workers' Compensation's provisions of Me Labor Code,- you must forthwith
comply with such provisions or this permit shall be deemed revoked. - -
MIf11rT1Um Setback-
e fback- Distances:
,. .. ..
Front Setback from Center Line
Rear Setback from Rear Prop. Line'
_
i. 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
Lenders Name
' -t
Lender's Address~
. FINAL DATE
INSPECTOR
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.
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'
Mailing Address
Validation:
City, State, Zip
-
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I SO. FT.
WALL SO. 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
1
FORMS l/
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.
LAUNDRYTRAY
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 ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
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 VPLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBING 01
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
1
FORMS l/
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF. "Ilk
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL l
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM l4l`� L�?
ILLL [vim
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-
NSPECTION
CERT.
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL