003192 (SATT)P.O. BOX 1504 NO. 003192
Building 78-105 CALLE ESTADO
Address SA -47-4 OAU Will LA QUINTA, CALIFORNIA 92253
Owner
stmrise comp=y
Mailin
Address !i-OOS Comtry .Club Drim
City Zip Tel.
Palsy Desert. ... 92260 . 568-28,28.
Contractor
Natiawl Mortgage IS UwA
Address
BUILDING: TYPE CONST. OCC: GRP
A.P. Number PGA West.
Legal Description
Project Description Phase 30-A8 F P.m
S =
City ]Zip
ZONE:
Tel.' "
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
Minimum Setback
State Lic.
& Classif.
•
City
Lic. #
Sq. Ft. D 1633.
Size A-
No. No. Dw.
Stories Units
Arch., Engr.; -'
Designer
New ❑ Add ❑
Alter ❑. Repair ❑ • Demolition ❑
Address
Tel.
CONSTRUCTION LENDwc.ACENcv
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
City
Zip
State
_
Side Setback from Property Line
Lic. #
LICENSED CONTRACTOR'S DECLARATION
FINAL DATE
INSPECTOR
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
effect. r .. f
-
,
SIGNATURE - DATE_
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
EStlmated VdlUatlOn
a
$1.13p'727.00reason:
(Sec. 7031.5, Business and Professions Code: Any city or county which requires a
"
.
YPERMIT
AMOUNT
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's License Law, Chapter 9 (commencing with -Section 7000) of
Division 3 of the Business and Professions Code, or thathe 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 penalty of not more than five hundred dollars'($500):
0 I,, as owner of the property, or my employees with wages as their sole compensation, will
'
Plan Chk. Dep.
'
Plan Chk. Bal.,
"Uhl IAA
"Const.
' l�
do 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
Mech.
' -
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
Electricalr
>t
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 or sale.) ,
Plumbing
AT CA
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
S. M. 1.
- 7 OF%
Grading
-
Driveway Enc.
Date Owner
Infrastructure
ti 7tl�e+_�6
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
❑ Copy is filed with the city. O. 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 thg 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.
TOTAL 09. 94!"9t
REMARKS t1f 4 47 1 cl 5Q?,) tit, -')z -a? 1 i ? .
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 LENDwc.ACENcv
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 Js correct.
Issued by:
Date 419, /A7 Permit
- I agree to comply with all city and county ordinances and slate 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
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®'
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. I SO. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
�i
SEWER OR SEP 1 iA
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
/1
(%loor
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.
SQ. FT. RESID ® 11/4 C
SEWAGE DISPOSAL
BOND BEAM
SQ.FT.GAR ® 3/aC
HOUSE SEWER
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 O
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
�i
SEWER OR SEP 1 iA
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 7 ��
/1
(%loor
GAS (ROUGH) /v ��
y 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. r 9
FRAMING ,
F AL. INSP.
ROOFING //,
vv
7�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND q,
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL