003190 (SATT)Building
Address 55-009 Oak E111.
Owner
sr rP AA cayman
Mailing
Address 75-005 Comtry C
City Zip
Palm .Desert.92260
Contractor
iGtrlP4m�r�� 1i7a1t'tr�a�w
Address
V�isJ
QUA&
P.O. BOX 1504 N 0. 003190
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
Drive A.P. Number - PGA West
Tel.
Legal Description.
Project Description Phase 30A, PlAn
City Zip Tel.'
State Lic.
& Classif. 2�
Arch., Engr., '
Designer
Address
City
Lic. # 3.26 Sq. Ft. D76 1627
Size r - .424
New ❑ Add C
Tel.
No. No. Dw.
Stories Units
Alter ❑ Repair ❑ Demolition ❑
City
Zip
State
. .
Lic. #
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
effect.
SIGNATURE `- - - DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
yq
N.g$ ���
$
' reason: (Sec. 7031.5,Business and Professions Code: Any city or county, which requires a '
permit to construct,' atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for, such permit to rile a signed statement that he is licensed, pursuant to
PERMIT - AMOUNT
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 theiefrom, and the`'basis
- -
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a'permil
Plan Chk. Dep.
' subjects the applicant to a civil penaffy 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
G�a�
Cionst. �?
_ Professions Code: The Contractor's License Law does not apply to an owner or property who
s+7
.
builds or improves thereon and who does such work himself or through his own employees,
Mech. 3b
. provided that such improvements are not intended or offered for sale. If, however, the building
-have
s-bs
or improvement is sold within one year of completion, the' owner -builder will the burden
Electrical 67041
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 87.50
slruct 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. 1. �,
such projects with acontractor(s) licensed pursuant to the Contractor's License Law.)
d . '
Grading
❑ I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure 1.,705.91
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. ❑ Certified copy is hereby furnished.
TOTAL�y7Ja�
_
CERTIFICATE OF EXEMPTION FROM
REMARKS
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
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 state that the above information is correct.
'and
®/�/J!
Issued by: Date ® Permit .
I agree to comply with all city 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
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
i
I
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. 1 SO. FT. ®
CARP. 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
FLOOR DRAIN
I MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN i EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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 4FORCED GRAVITY
AMPERES,SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. ® c
BATH TUB
1
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
,/
FINAL INSP. �C{�
ROOFING Gf j�7
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 I PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
/r}
14.
GROUND PLUM ING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE I
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS l
SEWER OR �7
OUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 7
GAS (ROUGH) /,g
*OMETER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL I
GAS (FINAL)
TEMP. POLE
GROUT }
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM 1
WATER SYSTEM
GRADING
CU. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. 1/
FRAMING 91"1171 d
,/
FINAL INSP. �C{�
ROOFING Gf j�7
'
.
REMARKS:
VENTILATION
FIRE ZONE ROOFING
r
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
l
,
LATHING
MESH
i
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
t
FENCE FINAL j. .
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL