002329 (SATT)4 4. 11 0 ..
P.O..BOX'1564 No. 002329
Building 78-105111CALLE ESTADO
Address 54-325 Oak RM LA QUINTA, CALIFORNIA 92253
Owner
Mailing
BUILDING: TYPE CONST. OCC. GRP.
,
Address 75-005 Cb361txv Club Er. A.P. Number
City Zip JTel.
Pal �£ 92260 5158 - $ Legal Description
ContractorProject Description Pry Ts"'Um ° t M
int.. t2ntwm and Lisid PhaW 5 A
Address
City Zip Tela
Sam
State Lic. City
& Classif.. 288130 Lic. # 328
Arch.- Engr.,
Designer
Address Tel.
Sq. Ft. DW 1330No. No. Dw.
Size MR 42A Stories 1 Units '
New QC Add ❑ Alter ❑ Repair ❑
City Zip State
L
ic: y _Tic:#
LICENSED CONTRACTOR'S DECLARATION
I 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... a
SIGNATURE V t A DATE _
• �• �'' 'OWNER BUILDER DECLARATION
1,-
I hereby affirm that 1 am exempt frogi 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 do
the provisions of the Contractor's -License Law, Chapter 9 (commencing with Section 7000) of
Estimated Valuation ��+n
'�iJ4'tl a
PERMIT
'
Divisfori'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
-
Plarl Chk. Dep.
' subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 1 .-
0 I, as owner of the property, or my employees with wages as their sole compensation, will.
Plan Chk..bal.
Const.
do the work, and the°structure is not intended or offered•for.sale. (Sec: 7044, Buisness and
Code: The Contractor's License Law does not apply to an owner of property who
Mech. .
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
Electrical '
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.) . .
Plumbing
❑ 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
S.M.I. .
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
0.I am exempt under Sec. B. & P.C. for this reason
Grading
Driveway Enc.
f t
Date Owner
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
0 Copy is filed with the city. , ❑ 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 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.
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 sof this city to enter the above-
mentioned property for'inspection purposes,.
Signature of applicant F. 1 > •_%x✓ Date
Mailing Address
City, State, Zip
i
HARD COPY
In rastruc ure
Sebool. .
TOTAL
Demolition ❑
AMOUNT
324.94
391.00
34.00
87. so
5.99
1,276.80
628.00
r1CIVIAt-5N.7 - 4rUV I .'44F.
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 21" 86Permit
Validated by:
Validation:
A 5 3 4 Z
4 Z 1 8 I,%, 4 2 C k
CONSTRUCTION ESTIMATE ANN,
NO. ELECTRICAL EEjgIjk
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. 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
P42eAOUGH PLUMB. /C
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
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a C
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
�uGFRAMING 4 6 P /
FINAL INSP.
GAS PIPING
PERMIT FEE
KJZ Al2 ��/ � ,eg
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
G/eGROUND PLUMBIN—
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
P42eAOUGH PLUMB. /C
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
�OUGH WIRING eF�v
DUCT WORK
ROCK STORAGE
f4//FOUND. REINF. O
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
/J REINF. STEELS
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
�uGFRAMING 4 6 P /
FINAL INSP.
bl(�-ROOFING O /5�
O
��/� oJC T6
KJZ Al2 ��/ � ,eg
REMARKS:
e
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
;1/4 -LATHING
MESH
�61NSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL
4�G fr1/6o
1VM"D biur4AI uKrbi i1IALb.