002292 (SATT)Building 54-'457 Oak Hill
Address
Owner
&UW42e ObMany
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 0,2292
BUILDING: TYPE CONST. - OCC: GRP.-
Address
RP:
Address 75.005 club– ix.
A.P. Number
City
Zip
Tel.
.,Palm Dom_ _
922619
568 2ne,,
Legal Description
Project Description
PM V MW 2
. Contractor
Address
Sam
City
Zip
Tela
State Lic.
Cityi
& Classif.. 288130
Lic. # 328
Sq. Ff. Mq A24 No. 1 No. Dw. i
Size Stories - • Units
Arch., Engr.,
Designer
New Add ❑
. Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
_I
. .
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 forcepnd
effect. i .
Fr, /%• %{, t
SIGNATURE d d / " . / DATE
TOWNER -BUILDER DECLARATION
I hereby affirm that I am exemptAfrom the Contractor's License Law for the following
Estimated Valuation
$ 97,6q
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 to file a signed statement that he is licensed pursuant to
the provisions of the Contractor'slLfcense Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or thaf.,he'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 p`enafty of not more than live hundred dollars (8500).
• ❑ I, as owner of the property, or my employees with wages as -their sole compensation, will
do dhe work, and the structure -is not intended or offered for. sale. (Sec. 7044, 8uisness and
.. Professions Code: _The Contractor's License Law does not apply to an owner of property who
builds •., 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-
23.00
PERMIT
- AMOUNT
Plan-Chk: Dep.
Plan Chk. Bal.
.
Const.
Mech.
�.
Electrical
sIG 15
65..44
Plumbing
81.50
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
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
.0.1 -am exempt under Sec. B. & P.C. for this reason
S.M.I.
6.83
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' - Ihereby 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
2,, 4377
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed if the permit is for one hundred dollars (8100) 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.'
ZONE: BY:
Minimum Setback Distances:
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
FINAL.DATE
ISSUed by:
Validated by:
Validation:
A5155
INSPECTOR
4—��
Date Permit
4 10. X437,17 '6K
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-
bovementioned property for inspection purposes.
mentioned
Signature of applicant S,:, —Date—
ateMailing Address :�• . "i'.r' f'
Mailing
City, State, Zip f
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEEF'4
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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 PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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
FINAL INSP.
ROOFING
+,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
IMJr CIiI VA J JIV I�NI VnCJ/ILII I INLJ,
GARDEN WALL FINAL