002611 (SFD)P.O. BOX 1504 N'o, 00261
Building78-105 CALLE ESTADO
Address 54-0 Clink R111 LA QUINTA, CALIFORNIA 92253
Owner
Mailing.
Address
_ '7C..,.['11t1 fVvietti+l�aas t'� .��: Tkw•S*
City _ Zip el:
-P�' .92260.. 568—,2$28.
Contractor
Address ., .
City._ Zip Tel'.
sawY'M1 M d
BUILDING: TYPE CONST: OCC: GRP:'"
A.P. Number
Legal Description
Project Description' V W r-.•REMM
-
State Lic.
• & Classif. - =13o
City
Lic. # . 328
Sq. Ft.' ' rM
EM NII59118 No: Dw.
Size - -1
424 Stories Units'
Arch.; Engr.,
' Designer
New M Add -O Alter O Repair O . Demolition O
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
.effect. ..�i p..
SIGNATURE DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
hereby affirm that 1 am exempt from the Contractor's' License Law for the following
@ g y•� �r "� .}}Yy
reason: (Sec. 7031.5,Business and Professions Code:.Any city or county. which requires a
• +� «`.�w9`;7• «ss ++ .
• 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'
- -• PERMIT'
AMOUNT -
the provisions 0/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of:
.s
Division 3 0/ the Business and Professions' Code, or that. he is exempt therefrom,' and thebasis
/or the alleged exemption. Any violation Section 7031.5 by 'any for
-Plan. Chk.: Dep.
••
• - of, applicant a. permit
` subjects the applicant to a civil penalty of not more than five hundred dollars .(S500).-
Plan Chk. Bal. "
-
0 I,_as owner oftheproperty, or my employees with wages as their -sole compensation, will,
e� do the work, and the structure is not intended or offered for sale. (Sec. -7044, Buisness and., '
Professions Code: -to
Const. '"
,60
• Y` /�
The Contractor's License Law does not - apply. an owner of property whoJW
' builds or improves thereon and 'who.does such work himself or through his own employees,
that'
Mech. - -
ssii3
- 34.00 _.•
'
provided 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
Electrical74.69-
of proving that he did not build or improve for the purpose of sale.) , . -
, .
0 1, as owner of the property, am exclusively contracting with licensed contractors to con.,
Plumbing.
89.E
• Strutt the -project. (Sec: 7044, Business and Professions Code: The Contractor's License Law ,
-
does not apply to an owner o/ property who builds or Improves thereon,, and who contracts for
S.M.I' '•
-- - " - ci .
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
e
• f] I am exempt under Sec.. B. 8 P -.C: for -this reason,
Driveway Enc.
Date owner
Infrastructure
L805.97
WORKERS' COMPENSATION DECLARATION
" I hereby affirm that I have a'certificate of consentto self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 9800, Labor Code.)
- ..
• 'Policy No. •' .Company -
0 Copy is filed.with the city. . 0 Certified copy is hereby furnished.
TOTAL
2.291.56
• CERTIFICATE OF EXEMPTION FROM .'i•• -
',.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 thg 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 provisions 'of the Labor Code,' you must forthwith
comply with such provisions or this permit shall be deemed revoked. -
_
Minimum Setback Distances:
Front. Setback from -Center Line
Rear Setback from Rear Prop.. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Ce.nter.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
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.�41r"f
I certify that I have this
t}
read 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 authorizerepresentatives of this city to -enter the above-.
_ mentioned property for inspection purposes. f i
Validated by.:
y
Signature of applicant fJ Date
Mailing AddressValidation:
City, State, Zip J.
r
A 6 4 3 6
9 3U 2891.56 fl }
HARD COPY
r
�—
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO, 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
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
OUGH WIRING `?�,�
J�
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCKSTORAGE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
METER LOOP
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
P USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
E,TEMIPERM
[AMPERES
LAVATORY
HEATING SYSTEM FORCED GRAVITY
SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SERVICE
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
WATER SYSTEM
SQ.FT.GAR ® 3/ac
HOUSE SEWER
$
GRADING
cu. yd.
plus x$
GAS PIPING
PERMIT FEE
PERMIT FEE:d I
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
JILAROUND PLUMBING,.
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC %N,K
OUGH WIRING `?�,�
J�
DUCT WORK
ROCKSTORAGE
�L FOUND. REINF./v
jQ6GAS (ROUGH) / /
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
,/GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
geINAL
INSP. a
v
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR'
4teFINAL INSP. /�.• `..��
FRAMING
FINAL INSP. n ^7/��''
.L(�
ROOFING
f� ..
Qac Tv w
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A.
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 3
MESH
p` INSULATION/SOUND 1,2,jr?
FINISH GRADING
FINAL INSPECTION 21.2
CERT. OCC.
FENCE FINAL
IIYJYCI:I V N"J JIIaMA I V nGJ111Y1 I IMLJ,
GARDEN WALL FINAL