002614 (SATT)Building
Address
Owner
P.O. BOX 1504, N O . 002 -614
78-105 CALLE ESTADO
�1 LA QUINTA, CALIFORNIA 92253
Mailing
Address 75^`5��.�Vla
City Zip Tel.
, .' .Paka' W ft 92260- 1 -568-2828, .-
Contractor
Aaaress ..
City -- . -..- ._ Zip Tel.
State Lic. City
& Classif: 2>�1� nO Lic. # 328
--Arch., Engr.,
Designer
BUILDING: TYPE CONST. • OCC: GRP.
A.P. Number
Legal Description
Project Description _DM V= F9M 13,A
P1 =13A ,
'x 154£3.
Sq. Ft.' No. No. Dw.
Size. -• 424 Stories Units
New
Add ❑ • Alter ❑' !: Repair ❑
Demolition ❑ ~
Address
Tel.
City
Zip
State
Lic. # _. . .
LICENSED CONTRACTOR'S DECLARATION , .
"
hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions' Code, and my license is in full force -and
a'
effect. ,
SIGNATURE -__ DATE
... - . ........ ' .. . , .. . . .. ..
OWNER -BUILDER DECLARATION " '
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
'reason: 7031.5,Business Code: Any
�.0 '
(Sec. and Professions city or county which requires a _
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
. •
ar • - - - -
t. 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. fie is exempt therefrom, and the basis •
for the -Any Section 7031.5 'any for•
-- - .•,.
Plan. C.hk. Dep.-...
alleged exemption. violation of by applicant a- permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).' -'
' 1, as
.. •.3 HC "' ' '
Plan.-Chk., Bal.
❑' 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
- ..• - - -
COr1St. 427.00
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.' •a
'provided that' such improvements are not intended or offered for sale. If, however, the. building
y -�S t7
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.) . --
-
• ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing�m�?I
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law_ .
••
does not apply to an owner of property who buildsor improves thereon, and who contracts for •
S.M.I.
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.). -
Grading
..0 Lam exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner
1t
Infrastructure,s�dCA46s3
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. -.
TOTAL
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 Owrier
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you .should become
ZONE-- '• BY:
r`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 Distances - - - '
t
Front.Setback.fTom Center Line
Rear Setback from Rear, Prop, Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from,Center Line-
hereby affirm that there is a construction lending agency for the performance of the
- : , •
.work for which this pertnit is issued..(sec. 3097, civil code.)
Side -Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE 'INSPECTOR
• This is a building'permil when properly filled out, signed and validated, and is subject to `
expiration if work thereunder is suspended for 180 days. -
�p
^•;��7
• I certify that I have read this application and state that the above information is correct.
'
-Issued by: Date '7 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=.r
mentioned property for inspection purposes. ,r '; - ✓
Validated.by:
�f
Signature of applicant Date •"""*�'_f`�c�
._
_
Mailing Address
Validation:
City, State, Zip
A6:433 9'- 3C 2437,17 Ch
HARD COPY
CONSTRUCTION ESTIMATE Adk
NO. ELECTRICAL EESS
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
FOR. SQ. FT. ®
GAR. SQ, FT. ®
CAR P. SQ. FT.
WALL SQ. 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
SLAB GRADE ` (�+
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
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.
SQ. FT. ® c
BATH TUB
WATER HEATER
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/a c
SEWAGE DISPOSAL
BOND BEAM
SQ.FT.GAR ® 3/ac
HOUSE SEWER
$
GRADING
cu. yd.
plus x$
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/O— :/ —�—
ROUND PLUMBIN Q„
/
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ` (�+
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPT T
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
AS (ROUGH) %ZI&
!
,q
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
�C REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
Y,6VFINAL INSP. 2(7� 1
NRAMING
�
� FINAL INSP. �
ROOFING! ccx III D'6 � /
VENTILATION
�'/ -rt,
� �OL
W16A 1% 9`
�
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL