002322 (SATT)Building int E11
Address 56-349
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 75-M Omatry ClUb Dr.
City Zip Tel.
92260 568-2 '
Contractor
`l fftftgaw auld TAW
City ]Zip Tel.
State Lic. City
& Classif. 288138 Lic. # 328
Arch., Engr:,
Designer
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
70 00'
of Division 3 of the Business and Professions' Code, and my license is in full force and
effect.. i y'
-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, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit ld 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 thathe 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). -' '
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.) .
❑ 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
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
❑ Copy is filed with the city. 0 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 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, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 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 it 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 inspectior.,purposes.
Signature of applicant- ` Date
Mailing Address
City, State, Zip
HARD COPY
No. 002322
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description VIM l4�1c ]SAN 4 d
Pham 5 A
Sq. Ft. MG 1 918 No. No. Dw.
Size M 424 Stories 1 Units
New 13A Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$ 120,398-00
BY:
'PERMIT
t
AMOUNT
Plan Chk. Dep.
Plan, Chk. Bal.
395.60
Const..
485.50
Mech.
34.0'0
Electrical
74.69
Plumbing
87.50
S.M.I.
8.30
Grading
Validation:
Driveway Enc.
A 5 3 3 61
Infrastructure
1,005.97
TOTAL
Z
REMARKS
3,519.56
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 4-21-86 Permit
Validated by:
Validation:
A 5 3 3 61
4 21 3;19,56 CK
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. 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
i2eOUGH PLUMB. r
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)
LAUNDRYTRAY
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
fte_FRAMING /
FINAL INSP.
GAS PIPING
PERMIT FEE
- PERMIT F
PERMIT FEE
DBL
L--
TOTAL FEES
I
MICRO FEE
I T
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
I .EE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBING3
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
i2eOUGH PLUMB. r
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK,ROUGH
WIRING / e
�a
DUCT WORK
ROCK STORAGE
&KFOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
�EINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
fte_FRAMING /
FINAL INSP.
aROOFING Z ?
ntlrJ J
�L(� 0,C • 7Ci w yeA�
,P
V ���p� &�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE. FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
gue <C / pi, �'�/