002430 (ELEC)44
P.O. BOX 1504 No. 002430
Building78-105 CALLE ESTADO
,,,86 ,
Address ) LA QUINTA, CALIFORNIA 92253
Mailing'
sunrim BUILDING: TYPE CONST. OCC: GRP. -
Address
A.P. Number,
CityZip Tel.
�$i t i> . 922 .568'2828 Legal Description
Contractor Project Description
Ifttl. lmo. "rte YIM1;3
Address.
I certify that in the performance of the work for which this permit is issued, I shall not
'
City
a,
Zip -
Tel.
Laws of California.
State Lic.
& Classif.. 288330
City
Lic. # ' 32,13
Sq. Ft. No. No. Dw.
Size Stories - Units
Arch., Engr.,
Designer
New ❑2,S Add ❑ Alter ❑ Repair ❑ .
-Demolition ❑
Address
Tel.
. ;6 for Mama 3. 4
5 A
City
Zip
State
Lic. #
_
Side Street Setback from Center Line
LICENSED CONTRACTOR'S DECLARATION
I 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 force and
affect. .. .
work for which this permit is issued. (Sec. 3097, Civil Code.) -
-Side
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
_reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
• permit' to construct, alter, improve, demolish, or repair any • structure, prior to its issuance also-
• requires, the applicant for suchpermitto file a signed statement that he isdicensed 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 that. 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 toe civil penalty of not more than fivehundred dollars (5500).
❑ 1, as owner, of the,property;.or my employees with wages as their sole compensation, will
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,
prorovided.lhat'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.)
❑ I am exempt under .Sec. B. & P.C. for -this -reason
Estimated Valuation
+�y
PERMIT AMOUNT
- -
-
Plan Cllk. Dep. .-
-
Plan. Chk. Bal..do
COnSt.
Mech.
:Electrical 140.E -
.
_
Plumbing
S.M:I:
Grading
Driveway Enc.
Date Owner
Infrastructure
G�jS0B Permit
Date
I agree to comply with all city and county ordinances and state laws relating to building
WORKERS' COMPENSATION DECLARATION
' I hereby affirm* that I have a certificate of cohseht'to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
• [i. 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 ) ' . -
construction, and hereby authorize representatives of this city to enter• the above-.
mentioned property for inspection purposes.
Validated by:
TOTAL
.
140.00
REMARKS
Mailing Address -
Validation:
'
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
'ZONE:
BY: -
- subject to the workers' 'Compensation provisions of .the Labor Code', you must forthwith
comply with such provisions or this permit shall be deemed revoked. -
.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
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:
®
I certify that I have read this application and stale that the above information is correct.-
Issued by:
G�jS0B Permit
Date
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 inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address -
Validation:
'
City, State, Zip
A5856
6 24 t'4'11'00 C�
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. S0. FT.
POR. SO. FT. p
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. 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
I
I WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(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,TEMIPERM
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 1
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
r%.i VmT oiumN1VACJIIIYIIINLb.
GARDEN WALL FINAL