002310 (SATT)I_0�"#4
! -
1
I I
Building
Address 54-265 0& X11
Owner
Mailing
Address 75 -WS Counf= Club
City lZip ITel.
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
POM Desut 922 8-2828
Contractor
Address ..
No. 0023.0
BUILDING: TYPE CONST: OCC: GRP.
A.P. Number
Legal Description
Project Description M WfigT' FILM 2 4
PbjELW 5 A
s
City ..
Zip
Tela .
saw
State Lic.
City1548
& Classif. .,
Lic. # 32s
Sq. Ft. No. No. Dw.
Size -•� 424 Stories Units
Arch.; Engr.,'
Designer
New ❑IA 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 9 (commencing with'Section
7000) of Division 3 of thea
.Business nd.Professions Code, and my license is in full forceand'
effect,
SIGNATURE r DATE
.... .,..
`rOYUNER-BUILDEIi�DECLARATION^
EStlmated Valuation
I hereby affirm that I amiexempt from the Contractor's License Law for the following
n•�
reason;/(Sec, 7031.5,Business and Professions Code: Any city or county ,which requires .a
'permit
7 0
'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
Any violation Section 7031.5 'any for
-
Plan Chk. Dep. -
for the alleged exemption. of by applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
.
Plan Chk.. Bal.
3S2.QnAr5L
❑ 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.
r"y�.7./.ryu
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.
34.00
. 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
Electrical
65.44
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.
6..83
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
❑ I am exempt under Sea B. & P.C. for this reason
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
O Copy is filed with the city. .O Certified copy is hereby furnished.
TOTAL
2,437.17
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 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
ZONE: BY:
subject' to the Workers' Compensation provisions of the Labor Code, you must forthwith
Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Minimum
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.
�, �,�
I certify that I have read this application and state that. the above information is correct.
Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws 1relating to building
construction, and •hereby authorize representatives got this city to enter the above-.
mentioned property for inspection purposes.
Validated by:
y.
Signature of applicant �' f#' .:. • s Date •' f f+
Mailing Address `
Validation:
City, State, Zip r
A532..b 4._ 21 2457,1.7 LK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EESaINL
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CARP. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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.
SQ. FT. ® c
BATH TUB
WATER HEATER
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 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
ROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
44,CPUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
A:I�OUGH WIRING
DUCT WORK
ROCK STORAGE
ecieFOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL a
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
)(�CFRAMING If. G
FINAL INSP.
ROOFING �,
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f
REMARKS:
VENTILATION
FIRE'ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
yb LATHING !�
MESH
'LkJNSULATION/SOUND nO
C�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
mbrecium )awnsiumrwiniIiwLs.
GARDEN WALL FINAL
f c�,L- S( /&/ 5 --Co 0P-.(.vYD, iC.