002595 (SATT)Building 5es121 CU
Address
P.O. BOX 1504
78.105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No.. 00 595
swwise
BUILDING: TYPE CONST.
OCC: GRP.
Mailing
Address 7ci,.jbA.P.
Number
Cityp
Tel.
���__c7tz,
P� 92M
-%&!-28n
Legal Description
Project Description
t -11M PIW- A
Contractor
s4�il.nFxa t
PUM, 2 M
Address
City'
Zip-
Tel.''
State Lic.
& Classif. 288130
City
Lic. # 328
DW 1548
Sq. Ft. No. No. Dw.
Size GM AN Stories ' Units
Arch., Engr.,
Designer
New Q. Add ❑
m
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
�I
a
hereby affirm that I am licensed under provisions of Chapter 9 (commencingwith Section
7000) of Division 3 of the Business and Professions Code, and my. license is in full -force and
effect..,,,,. y
SIGNATURE DATE`
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5, Business and Professions Code: Any city or county which .requires a
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
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:five hundred dollars ($500).
D I, as owner of the property, or my employees with -wages as their sole compensation, will
Estimated Valuation
C �? ��3���
Y' tt
- PERMIT -
'
- AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
352.05
Const.
�.
_
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 or improves thereon and who does such work . himself 'or through hisown 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.) -
Mech.
- 3�y�ti
ElectrlCdl
�p
!t
slt
Plumbing
87.5+0 .
0,1, 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
_.
S.M.I. .
�C Q
- 6.83
_
Grading
Driveway Enc.
Date owner
Infrastructure
1,464.35
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
2,437.17
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(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 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.
ZONE: BY:.
..Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING.AGENCY
Side Street Setback from Center 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
FINAL DATE
Issued by:
INSPECTOR .
a4_ _ �93, �G
Date Y 3 Permit
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 Address
Validated by:
Validation:
A6+26
9 50 i4�7,1i LK
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FE
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO, FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO 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
(,BOUGH PLUMB. 9 .�
FLOOR DRAIN
MECHANICAL FEES
STORAGE TANK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
AS (ROUGH) �p
16
LAUNDRY TRAY
AIR HANDLING UNIT CFM
OTHER APP./EQUIP.
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.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
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
'3' ROUND PLUMBING/0_ -
UNDERGROUND
A.C. UNIT
COLL. AREA
`/ SLAB GRADE
(,BOUGH PLUMB. 9 .�
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
14eSEWER OR SEPTII/r K
Qy(�fSOUGH WIRING /
F�
DUCT WORK
ROCK STORAGE
7 FOUND. REINF. f/
��
AS (ROUGH) �p
16
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL .,
l
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
fC4_fl.NAL INSP. ( `
�O I
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
KEINAL INSP.
W&RAMING /� /
`
FINAL INSP.
��ROOFING
nr. 1-14 1a►Q,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
Le-INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I brGG 1 Un"J WUNA 1 UnrWINI 1 IALb.
GARDEN WALL FINAL