04906 (SFD)4
P.O. BOX 1504 No. 04906
Building 49-100 Marimba Court LA QU NTA CALIFORNIA 92253
Address _
Owner
Sir Con Development
Mailing BUILDING: TYPE CONST. OCC: GRP. -
Address 68-713 Perez Road #1 A.P. Number Parc Lit. Quint.a
CityZip Tel.
Cathedral City 92234 773-'302 Legal Description
Contractor Project Description Plan 2222, Pha-se X
Same
Address Lot 44
State Lic. 337077 (City
& Classif. Lic. # 1219
Arch., Engr.,
Designer
Address Tel.
City IZip IState
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I,am licensed under provisions of Chapter 9 (commencing with Section
70 ) of Division 3 of the Business and Professions Code, and my license is in full force and
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License taw for the following
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 rile a signed statement that he Is licensed pursuant to
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
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500).
❑ 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
builds orsnproves thereon and who does such work himself or through his own employees,
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
of proving that he did not build or improve for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
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
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
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. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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: d, 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.
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name
Lender's Address
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 certity 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
,Sq. Ft.
Size 2222
No. No. Dw.
Stories 9P Units
New ❑ Add ❑
Alter ❑ Repair ❑ -Demolition ❑
Estimated Valuation
$112 ,161
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 387.64
Const.
465.50
Mech.
53.00
Electrical•, "`
85.19
Plumbing
98.00
S.M.I.
7.88
Grading
Driveway Enc.
Infrastructure
2,523.63
t .
TOTAL
$3,620.3 j .i• - ' , f ^"r/
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
12/1/88
Issued by: Date Permit
Validated by:
-Validation:
CONSTRUCTION ESTIMATE
NO. -ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
1;13 T ROUGH PLUMB. BONDING
2N0 FL. SQ. FT.
STORAGE TANK
YARD SPKLR SYSTEM
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) G? @ ER LOOP
HEATING (FINAL)
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
CAR P. I SQ. FT. ®
FINAL INSP.
WALL SO. FT. ®
WATER SYSTEM
FINAL INSP.
INAL INSP.
DRINKING FOUNTAIN,
SQ FT ®
LUMBER GR.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GC fi
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FINAL INSPECTION
SQ.FT.GAR ® 3/<c
HOUSE SEWER
CERT. OCC.
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
n
BACK
R NO PLUMBING2t;PUNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE
1;13 T ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) G? @ ER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
INAL INSP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
ROOFING 6
GC fi
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING n et/ 7,/7/
MESH
INSULATION/SOUND 1
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
/
INSPECTOR'S SIG NATURESIINITIALS
'
GARDEN WALL FINAL
l