002267 (SATT)P.O. BOX 1504 No. 002267
Building c54:,6397Cak �. �. 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
E'er
BUILDING: TYPE CONST:
Mailing OCC:'GRP.
Address 75-005 CbTM't:rV ClUb MiVP A.P. Number
City Zip Tel.
SIM � 92260 Legal Description
Contractor Project Description PM U `A Q R
l�T;m�b � Fa�•sFa'h?•�±,1� :FArYlt � 4J�P4iRh _
Address .. .. ..
Phase 3, A
City Zip Tel:
skim
State Lic. City $may 19I1.2
& Classif. Lic. #�$ . Sq. Ft. 49A No. No. Dw.
Size Stories Units -
Arch., Engr:,
Designer New 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) W'Division 3 of the Business and Professions Code, and my licens�e. is in full force and "
effect. �r fv/ 7 - it/- ' = * --:
SIGNATURE f F' !.'i,?">" ,.O DATE _ .• _ ,.
-'OWNER•BUILDER DECLARATION
I f Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following yc4•f y!�1
reason:/(Sec. 7031.5,Business and Professions Code: Any. city . or. county 'which requires a '•a•u-3s aL7V .
permif to construct, after, improve, demolish, or repair any structure, prior do its issuance. also '.. -
requires the applicant for such permit to file: a signed statement that Be- is licensed pursuant to . ' 'PERMIT=AMOUNT
the provisions -.of the Contractor's License Law, Chapter .9 (commencing with Section 7000) of '
Division 3'of"tbe Business and Professions Code, or that. he is exempt therefrom, and the oasis -- . -
for the alleged exemption. Any violation of Section 703 1. 5 by 'any applicant r
foa permit Plan Chk' Dep. A
subjects the applicant to "a civil penalty of not more than five hundred -dollars ($500). Plan Chk. Bal. 395.60
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will s rte
do the work, and the structure is not intended or.offered for sale. (Sec. 7044, Buisness and CpnSt.. 4ta5.+aV
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. ogr0:
provided that' such, improvements are not intended.or offered for sale. If, however,' the. building
or improvement is soldwithinone year of completion, the owner -builder will have the burden Electrical - lS' '
. of proving that he did not build or improve for the purpose of sale.) g4.6p�..
❑ 1, 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 Contractors License Law -
does not apply to an owner of property who builds or improves thereon, and. who contracts for S.M.I. 8.30
such projects with•a contractor(s) licensed pursuant to the Contractor's License Law.)'
Grading
❑ Lamexempt under Sec. B. & P.C. for this.reason
Driveway Enc.
Date Owner Infrastructure 2,805.97
WORKERS' COMPENSATION DECLARATION
I•hereby affirm'th'at I have a certificate"of.'consent to self -insure, or'acertificate 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 2,891.56
CERTIFICATE OF EXEMPTION FROM REMARKS.
WORKERS'COMPENSATIONINSURANCE
(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, l 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 ,Minimum Setback Distances:
'
comply with such provisions or this permit shall be deemed revoked. -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY -Side Street Setback frornCenter 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. �e
• I certify.that I have read this application and state that the above -information is correct. Issued by: Date 4"• 00 f?ermlt
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-. r
mentioned property fo?•inspection purposes. : Validated by:
Signature of applicant X L?%1 -r D ri./: Date
Mailing Address k, "-i•./`" -� -- •"''-' - Validation:
City, State, Zip I it
A 5 1 7 0 _ 4 10 2891,56 U
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EEAft
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
V /,PAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
IKITCHEN 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
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
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
2jeSETBACK /j �VteROUND
PLUM!!
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
OleOUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SEP C �C
ROUGH WIRING`? `G,
DUCT WORK
ROCK STORAGE
TFOUND. REINF. L
r,
V /,PAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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.
�ZFRAMING
0
FINAL INSP.
i(,jLROOFING,� C
�
VENTILATION G
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
J LATHING
,
MESH
INSULATIONISOUND 7 a'i .
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL