002602 (SATT)• 44k
G���
P.O. BOX 1504 No. 402602
Building U-097 Oak RM LA QUINTA8-105 C
Address CALIFORNIA 92253
Owner
_SlmrisE'
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 75-005 00u3tXV Milb tki'm A.P. Number
City ZipTel.
Palm � 1 9225 . iii-2R2,R Legal Description
Contractor Project Description T4rlv-qp PMQP 17 is
i��i�ara<ail
Address lP zw?% A n
x�•tas!x�°,
City Zip Tel-.
State Lic. City ME 1918
& Classif.. � � � Lic. # � Sq. Ft. No. No. Dw.
Size- M .44 Stories Units
Arch.; Engr-,
Designer New IR Add ❑ Alter ❑. Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
_LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force•and
effect.
SIGNATURE - -''DATE ,
OWNER -BUILDER DECLARATION Estimated V81Uation yn
I hereby affirm that I am exempt from the Contractor's License Law for the following. iV Cis
reason: (Sec, 7031.5, Business and Professions Code: Any city or county which .requires- a J.V •aE3 •:rid
permit to construct, after, 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 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 Plan Chk. Dep. - A
'subjects the applicant to a civil penafty'of not more than five hundred dollars (8500). Plan Chk. Bal. 395
O I, as owner of the property, or my employees with wages as their sole compensation, will /�ey
do the work, and the structure is not•intended of offered for sale. (Sec. 7044, Buisness andCOnSt.485.50
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. _ '
provided that' Such improvements are not intended or offered for sale. If, . .however, the building -4_0
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
struct the project: (Sec. 7044, Business and Professions Code: The Contractor's License Law _.
doesnotapply,to an owner of property who builds or improves thereon, and who contracts for S.M.I. RAO
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
❑ I am exempt under Sec. B. 8 P.C. for -this reason Grading
Driveway Enc.
Date owner Infrastructure L 805;97
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. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
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 issuedi 1 shall not
employany 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
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 certify 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
ate Mailing Address
City, State, Zip
HARD COPY
TOTAL
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
Issued by: Date .9-3*46 Permit
Validated by:
Validation:
A 6 4 2 9 50 L56 61
CONSTRUCTION ESTIMATE Allikk
NO. ELECTRICAL FEE
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. I 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
OUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
(ROUGH)1 / 3 C n
4L O 1
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR.® 3/ac
HOUSE SEWER
FINAL INSP. // A
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
%CCSETBACK /..� ,�
ROUND PLUMBING'
UNDERGROUND
A.C. UNIT
COLL. AREA
GSLABGRADE,(6_'L �� (V
OUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
'`FORMS pv . ��
r(f (,EWER OR SEPT ToK�
v�
4ROUGH WIRING /
/
DUCT WORK
ROCK STORAGE
—Yh�AS
v(�FOUND. REINF. 9$�
(ROUGH)1 / 3 C n
4L O 1
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
P/ REINF. STEEL/O 4 �� ` (^
F�
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
INAL INSP., ,
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus —X$—=$
LUMBER GR.
gLe INAL INSP. �t /% 7
!ta
(2 n!1
5-11C (2A
FINAL INSP. // A
iG/ROOFING 0 z ); / Q (P
f IAJ �/�� Ia, �, (� '
ey (AJ✓ACL j /V� r ,G��O ✓� �� Zj/ /`"�``
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING s
MESH
INSULATION/SOUND' �� C
O
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE .FINAL
imAr=l iVn 0 JWnN 1 URMWIMI l 1ALA,
GARDEN WALL FINAL