002326 (SATT)4
P.O. BOX 1504 No. 002326
Building 78-105 CALLE ESTADO
Address 54-217 Oak HM LA QUINTA, CALIFORNIA 92253
Owner
BUILDING: TYPE CONST. OCC: GRP.
Mailing*
Address 75-005 CountrY ClUb Driw A.P. Number
City Zip Tel.
Pal
e 9fl 568-2 Legal Description
Contractor Project Description T ix -1
Natl Fingtrome m•is Tmg
Address RME 5 A
Sam
City Zip Tela
sam
State Lic. City n3O
& Classif. 28sim Lic. # 3 Sq. Ft. W 424 No. 1 No. Dw. I
Arch., Engr.;'
Size Stories Units
-
Designer New CIK 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..i+ ' 4 I _ �jr`I I ...
SIGNATURE /! e, ., d`r �, ,'sw�'ri . P DATE . ... .. .
16WNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation UQ•�n
reason: (Sec. 7031: 5, Business and Professions Code: Any city or 'county which requiresa
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also +
requires the applicant.for such permiCto 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. - -
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - Plan Chk. BBI. ae�
0 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 Const. .00
Professions Code: The Contractor's License Law does not apply to an owner of property who �2 Hff
builds or improves thereon and who does such work himself or through his own employees, Mech. 3 •.a,Ii.
provided that such improvements. are not intended or offered for sale. If, however, the building (�y0�
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 59.99
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 87.50
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. - 5.99
such projects with a contractors) licensed pursuant to the Contractor's License Law.) - -
Grading
❑ I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure IP276•UO
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 �oj�•�
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: 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 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
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. q
I certify that I have read this application and state that the above information is -correct. Issued by: Date -4-2146 Permit
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. f.. i Validated by:
Signature of applican - / i'f- a+. l.�+�' Date rl' 1,.
Mailing Address = ) ! Validation:
City, State, Zip l
��. AJSL8 4 21 42 U
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FFcdllk,
NO. PLUMBING FEES
IST FL. SO. FT. @ $ •
2ND FL. SQ. FT. @
FOR. SD. FT. @
GAR. 1 SQ. FT. @
CAR P. SQ. 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
BONDING
FLOOR DRAIN
I MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN # EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT I CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. i B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM i 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.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
J
SQ.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE j
PERMIT FEE
PERMIT FEE
DBL
TOITAL FEES
1
MICRO FEE MECH.FEE
PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE f PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK i(16oROUND
PLUMBING b
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
gfZRQUGH PLUMB. ,fle/f
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
(ROUGH WIRINGIf �r��
DUCT WORK
ROCK STORAGE
OUND. REINF. ?
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REIN F. STEEL
GAS (FINAL)
TEMP. POLE
GROUT j
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM j
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
/f1'�FRAMING ff /fr
(//1�J
F2��FlOOFING b
FINAL INSP.
�� J �_
O le- I O W it A�
p / S
o f/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE j
SPARK ARRESTOR I
GAR. FIREWALL .
/LATHING
MESH
i( INSULATION/SOUND 1ff, �� C
O
FINISH GRADING
a
FINAL INSPECTION
CERT. OCC.
FENCE FINAL }
e� 1 un a a1unH 1 vne�1n111nw,
GARDEN WALL FINAL
e L < -F//(/ �ll� 0e-I,/LA, is