002313 (SATT)Building 54-373 Oak, HM
Address
Iii 4 X
FII
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
sunx-Lsle
'Mailing
Address 75-005 COMtrY Club DriVO
CityZip Tel.
922605� -2828
3
Contractor
Natl VXwtqmqe_ Land
Address: .
'City Zip Tela
State Lic. I City
& Classif.. 298130 Lic. # 3M
Arch., Engr.,
Designer
Address Tel.
City Zip State
I. hereby
7000) of D1
effect... .
Lic-#
LICENSED CONTRACTOR'S DECLARATION
firm that I am licensed under provisions of: Chapter 9 (commencing with Section
sion 3 of the Business and Professions Code,.and my license is in full force and
DATE
' - OWNER -BUILDER DECLARATION
I hereby affi m that I am exempt from the Contractor's License Law for the following
reason:-' (Sec. .703 1.5, Business. and Proiessions Code: Any city or county which requires, a
peimitlto construct, after, improve, demolish, or repair any structure, prior to its issuance 'also
requires the applicant for such permft�to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's Lfcense 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. Anyf violation of Section 7031.5 by 'any applicant for a permit
subjects•the applicant to a civil,penafty 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.)
❑ 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
1 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. O 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
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 n � ..- r? °: i Dates
Mailing Address r`
City, State, Zip W
f
' HARD COPY
No. 002313
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description Ift T' pull 2 OR
PHIM 5 ,A -
Sq. Ft. EM 1548 No. No. Dw.
Size GM - 424. Stories 1 Units 1
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimated Valuation.
PERMIT
Plan .Chk. Dep.
Plan Chk. Bal.
Const. '
'Meeh. '
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
ScAlmo1 mitimt3.
TOTAL
REMARKS
97
AMOUNT
352 . 05
427..00
�eQt3
65.44
R7.50
iwYD��3'✓
62U.00
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
3-21-86
Issued by-
Date Permit
Validated by:
Validation:
A5338
4 21 3 65,"17 D,
CONSTRUCTION ESTIMATE
NO. ELECTRICALFEE-S
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. 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
(ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH.)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
OTHER APP./EQUIP.
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET`
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
1
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER,
FINAL INSP.
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 PLUMBINCl�'/�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
(ROUGH PLUMB.
BONDING
HEATING (ROUGH.)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
o&BOUGH WIRING C
O
DUCT WORK
ROCK STORAGE
2f,/ /FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
IC(� REINF. STEEL
GAS (FINAL)
TEMP. POLE
-
GROUT
WATER HEATER ,
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd. ,
$ plus x$
_$
LUMBER GR,
FINAL INSP.
(/FRAMING
O?/
FINAL INSP.
?a<::�ROOFING �/
jOelC O' T6 (�/Rn�
/
��l(OiCS �o
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
r%,I UM", WUNA 1 UMr WI17111ALJ,
GARDEN WALL FINAL
12 t «- r,i,f/fsf