002512 (RPL)Building 54-793 Oak F—
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. .002512
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
PIMProject Description PEPM. 3 A
Sq. Ft. No. No. Dw.
Size. .8X8 Stories -Units
New lJ Add O Alter ❑ Repair ❑ Demolition O
City
Zip
11
State
Mailing
. .
1 -
Address
7515 00WATV ClUb Dive
City
Zip
Tel.
palm Dase,t
92200
5II--28
Contractor
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
Validation:
reason: (Sec. 7031.5,Business and Professions Code: Any city 'or county which requires a
Address
% 3 1 17 3. 4 9 U
permit 20 construct,' alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement thathe is licensed pursuant to
68-465
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of .
City
`
Zip
Tel.
Q*b31r81 citv,
92235
328-2683
State Lic.
City
& Classif.
275196
Lic. # 169
Arch., Engr.,
Mech.
.provided that such improvements are not intended or offered for sale. If, however,, the. building
Designer
or improvement is sold within one year of completion, the owner -builder willhave the burden
Electrical
Address
Tel.
No. .002512
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
PIMProject Description PEPM. 3 A
Sq. Ft. No. No. Dw.
Size. .8X8 Stories -Units
New lJ Add O Alter ❑ Repair ❑ Demolition O
City
Zip
11
State
SW
. .
1 -
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I he affirm that Darn licensed undei provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the,Businessland' Profession`srCoft'and my license is in full force and
effect. r ' .s.- _ ::_ _ >� '' '
FINAL DATE
✓r
- SIGNATURE'" DATE
Date 7--31--86 Permit
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
Validation:
reason: (Sec. 7031.5,Business and Professions Code: Any city 'or county which requires a
A 5 1 1 s
% 3 1 17 3. 4 9 U
permit 20 construct,' alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement thathe is licensed pursuant to
PERMIT
the provisions of the Contractor's License 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
-
Plan-Chk.
for thealleged exemption. Any violation of Section 7031,5 by 'any applicant for a permit
Dep.
' subjects the applicant to a civil penalty of not more than five hundred dollars, ($500). `
Plan Chk. Bal.
❑ 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
Const.
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.
.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 willhave the burden
Electrical
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-
Plumbing
slruet 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.) -
Grading
❑ l am exempt under Sec. B. & P.C. for this -reason
Driveway Enc.
Infrastructure
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 affirmthatthere 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 lawsjelating to building
construction, and hereby authorize representatives sof this city Old enter the above-.
mentioned property for inspectiompurgoses.� i
Signature of applicant:.�""� '-i'�=r?9 •i Date - ?f e?
Mailing Address `g ` ✓ ✓
City, State, Zip
HARDCOPY
Ik:iF� a ld�'
AMOUNT
61.32
80.50
20.00
12.000
.67
TOTAL f, / 173.49
REMARKS,
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 7--31--86 Permit
Validated by:
Validation:
A 5 1 1 s
% 3 1 17 3. 4 9 U
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SQ. FT.
WALL SO. 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
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
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 APPJEQUIP.
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.
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL