002608 (SFD)P.O. BOX 1504 N0, 002608
Building 54-0
Address LA QUINTA, CALIFORNIA92253
Address -
Owner
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 7C _&.1!;
�� A.P. Number
City Zip JTel.
PRIM Legal Description
Contractor Project Description PM ` ;rr TMIRP7, 13 A.
Address
City Zip Tel.
State Lic. City
& Classif. 73� i�E1t Lic. #, Sq. Ft. v o No. No. Dw.
,
- Size MR 424 Stories- Units •
Arch., Engr.
Designer New 7R. Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address " Tel.
City Zip State
Lic. # -
__- 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 and Professions Code, and my license is in full•force and'
effect. . ... . I_
SIGNATURE DATE -
OWNER -BUILDER DECLARATION Estimated Valuation A A
I hereby affirm that I am exempt from the Contractor's License Law for the following Vt��sVif
reason: (Sec; 7031.5,4usiness and Professions code:- Any city or county. which •requires a V O
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also •.
requires the applicant dor such permit to file 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 thathe is exempt therefrom, and the basis - -
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. -
subjects the applicant to a civil'penalty of not more than five hundred dollars ($500). - -
0.I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. .324.94
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. 1
builds or improves thereon and who does such work himself or through his own employees, Mech. y♦ �y
provided that such improvements are not intended or offered for sale. If, however, the building lurk.
_ - -nn
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.) , QQ
❑ I, 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 improves thereon; and who contracts for S•M•I- >;�{
such projects with a-contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date owner -Infrastructure��-i�.�
WORKERS' COMPENSATION DECLARATION
hereby'affirnf-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.) -
Polioy 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 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: Il, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers" Compensation provisions -of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. - -
Front Setback from Center Line -
Rear Setback from•Rear Prop..Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
1hereby affirm that there is a construction lending agency for the performance of the
- work for which this permit is issued. (Sec. 3097, Civil Code.) $Idc 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 certify that I have read this application and state that the above information is correct. Issued by: Date Perfnit
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
A 6 4 3 8 9 30 42 11
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEESS
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®_
CAR P. SQ. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING/�
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS (ROUGH) z 1
/
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
WATER HEATER
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 VA 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 FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
(GROUND PLUM BING/ ,/
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
f4eSEWER OR SE C'SR
ROUGH WIRING/�
��
DUCT WORK
ROCKSTORAGE
FOUND. REINF. /
!
GAS (ROUGH) z 1
/
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
AS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
INAL INSP..g—X�,
ov'�tJJ
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FINAL INSP. 2
FRAMING /
Q/rFINAL INSP.3`.. F 7
ROOFING %f C� 12�f7r f5-V•Rc�
VENTILATION
c' 4 -f 6 VtJ ��P
�A �� �� NA,
r
1 F "�
L '1 1`31 G^1 0_
J D /
o��
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
,ALATHING
MESH
INSULATION/SOUND A
FINISH GRADING1
(� FINAL INSPECTION 2
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL