003193 (SATT).. Tit�t 4 a a Quin&
Building
Address 54-961 Oak Hill
Owner
Suarisa Campnny
Mailing
Address 75-005 Odmtry Club Drive
City
Palm Damm
Contractor
Net to
Address
Zip _ ITel.
92260-
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST.— OCC'. GRP.
A.P. Number PGA West,
568-2828 Legal Description
Project Description Phaset 30-A. PIs m 21MR
City lZip JTel:
State Lic. City
& Clas sif. 298130 Lic. # 328
Arch., Erigr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby the
that Iam licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of he Busin s s and Professions Code, and my licensd is in full.'force and,
effect..
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 such permit -to file a signed statement that he is licensed 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 theapplicant to a civil penalty of not more than five hundred dollars ($500):
0 1 as owner of the property,,or My employees with wages as their sole compensation, will
do ihe 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 -mill have the burden
of,proving that he did not build or improve for the purpose of sale.)
0 .1, 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 contractors) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date -Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm*that,l 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
. . . . mpany
0 Copy is filed with the.city. 0 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 thq 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: ff, 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 of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
MailingAddress
City, State, Zip
HARD COPY
HLMAHKS - - -I __ � - �m,A '1-t
rFVJ1u4N f-TOTAC f'
ZONE:—
BY:
Minimum Setback
Distances:
Sq. Ft. DUGJ033
-Size. - 424
No. No. Dw.
Stories Units
New 0 Add 0
Alter 0 Repair 0 Demolition 0.
Side Street Setback from Center Line
Side Setback from. Property Line
FINAL DATE
—INSPECTOR
Issued by:
Date A 11A /JQ7 Permit
Validated by:
Estirbated Valuation
5113.127.00
PERMIT
AMOUNT
Plan. Chk.. Dep.
Plan Chk. Bal.
380.44
Const.
460.00
Mec.h.
34.00
Electrical
67.41
Plumbing
87.50
S.M:I.
Grading
Driveway Enc.
Infrastructure
TOTAL
5"2.751A1
HLMAHKS - - -I __ � - �m,A '1-t
rFVJ1u4N f-TOTAC f'
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 A 11A /JQ7 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT, ®
CAR P. 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUG)O
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
_,61NAL INSP.
�/
ROOFING f l ` 0
v
GASHG
PERMIT FEE
PERMIT FEE
PEREE
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 SEP -14C TAN
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUG)O
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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. / 9
FRAMINGZy ��
_,61NAL INSP.
�/
ROOFING f l ` 0
v
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL,
LATHING �/l
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL