002594 (SATT)QUM&
-
4 4
P.O. BOX 1504 No. 00259
Building 78-105 CALLE ESTADO
Address 54-133 ('k HM LA QUINTA, CALIFORNIA 92253
Owner
Mailing
a" BUILDING: TYPE CONST. OCC: GRP.
Add --005 � Club A.P. Number
jp Tel.
Palm�� SS�d2i32 . '+� Legal Description
City __F
Contractor Project Description WW VM ' Pte'; 12 K
Address.. PIM 2'0
s
City Zip Tela
cep .
State Lic. _ City DW 1548
& Classif. 288130 Lic. # 328 Sq. Ft. No. No. Dw.
Size - Stories Units
-Arch., Engr.,
Designer New ❑X Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
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 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, youmust 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.�r+`' ,
Signature of applicant - %� �'iy �� s ! .f Date
Mailing Address
% t - ""� �✓ h
City, State, Zip
HARD COPY
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 9-30-86 Permit
Validated by:
Validation:_
A6423
9 30 4
City
Zip
-
State
iLic.#-
. LICENSED CONTRACTOR'S DECLARATION
I hereby affirm.that'l am licensed under provisions of Chapter 9 (commencing with Section
aan
7000) of Di/vision'3 of the.Business•and Professions Code, and my license is in fulbforrcceedd
- effect./
-
SIGNATURE t" -j ,� �' DATE
' �r 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 repairany 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 fora permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
O I, as 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
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,
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.) .
O I, 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.)-
.. ❑ I am exempt under Sec. B. 8 P.C. for this reason
Estimated Valuation , 97,623.0
V
PERMIT
AMOUNT
'
Plan-Chk. Dep.
-
Pian Chk. Bal.
tp9
d� • V�
(,Oust.
�Gl.ii�
Mech.�{�
Electrical
65.44
—
Plumbing
87.50
S.M.I.
6.03
Grading
Driveway Enc.
Date Owner
Infrastructure
1.46-44.35
WORKERS' COMPENSATION DECLARATION
Thereby 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)s hereby furnished:
TOTAL
Q 7.17
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 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, youmust 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.�r+`' ,
Signature of applicant - %� �'iy �� s ! .f Date
Mailing Address
% t - ""� �✓ h
City, State, Zip
HARD COPY
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 9-30-86 Permit
Validated by:
Validation:_
A6423
9 30 4
CONSTRUCTION ESTIMATE alk,
NO. ELECTRICAL FEEW, I
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
WLAB GRADE �O —�
2ND FL.SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
r —/ft6AS (ROUGH) / C
I O
DRAINAGE PIPING
WALL SO. FT. @
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
V `/&RAMING 1Z l�1 S
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:
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 ® 11/4 c
SEWAGE DISPOSAL
//GAR.
�44<ATHING
SO.FT.GAR ® 3/4c
HOUSE SEWER
MESH
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 PLUMBING 1070
UNDERGROUND
A.C. UNIT
COLL. AREA
WLAB GRADE �O —�
OUCH PLUMB. /G �6
BONDING
HEATING (ROUGH)
STORAGE TANK
�J,41`ORMS lU
SEWER OR SEPTIC TANK
AOOUGH WIRING a,
DUCT WORK
ROCK STORAGE
FOUND. REINF.
r —/ft6AS (ROUGH) / C
I O
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
If
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FVA INSP.
V `/&RAMING 1Z l�1 S
NAL INSP. A Q
./ROOFING b�Cle
VENTILATION d Y Y
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
FIREWALL
//GAR.
�44<ATHING
MESH
` INSULATIONISOUND /1 da
FINISH GRADING
cam]
FINAL INSPECTION 2r 3 a
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL