003188 (SATT)P.O. BOX 1504 No, 003188
Building 78-105 CALLE ESTADO
Address 55--033 ftk RM LA QUINTA, CALIFORNIA 92253
Mailing -'
Address 75-005 Country, Miff mve
City Zip Tel.
Faun Deam 92260 568--2828
Contractor
watiowi llartgage a Y $
Address.. 8
City' lZip Tel.
State Lic. City
& Classif. 288130 Lic. # 328
' Arch., Engr.;
Designer
BUILDING:- TYPE CONST. OCC: GRP.
A.P. Number PGA West
Legal Description
Project Description Pliese 30l- -A, .PIM I WX
. WIlding 2 ...
Address
Tel.
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Sq. Ft.
Size
D -q(;
G
133(). No.
.424 Stories
No. Dw.
Units
New-❑
Lic. #
Add ❑ Alter ❑
Repair ❑ '. Demolition ❑
Address
Tel.
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
City
Side Street Setback from Center Line
State
Side Setback from Property Line
JZip
Lic. #
INSPECTOR
Issued by: '
. LICENSED CONTRACTOR'S DECLARATION
by:
I hereby affirm'lhat 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
"
Validation:
• effect.
SIGNATURE__ - - DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
hereby affirm that I am exempt from the Contractor's License Law for the following
Q
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
-. PERMIT
+��
_
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 .(commencing with Section 7000) of
r
Division 3'df the Business and Professions Code; or that. he is exempt therefrom, and the basis
for the Any Section 7031.5 'any for
Plan Chk. De p
"
alleged exemption. violation of :by applicant a permit
subjects the applicant to a civil penalty of not more than'tive hundred dollars -(S500). -
Plan. Chk. Bal.
S U2„&Q
❑ I, as owner of the property, or my employees with wages as their sole compensation, will .
do the work, and the structure isnot 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 *will have. the- burden
Electrical
(�
of proving that he did not build or improve for the purpose of sale.) -
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
lqg
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
S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law:) -
Grading
❑ I am exempt under Seca B. & P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
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.. -
TOTAL
iaf1� i R � i Cr =i $ d OE,—ctt�t >a4�9 9fs 1
CERTIFICATE OF EXEMPTION FROM
REMARKS
IV i AWA 1 I U I RL Y P `''JOZ, c.rt
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
Date Owner
NOTICE TO APPLICANT: It, alter 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
Mailing Address
City, State, Zip
HARD COPY
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 6/2A/97 Permit
by:
,Validated
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
L GAS (ROUGH) �0
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
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
FRAMING / /�7 D
U/
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1114 c
SEWAGE DISPOSAL
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
v
GROUND PLU BING O
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TA
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. %Q
a
L GAS (ROUGH) �0
'-//METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP. /
GRADING
cu. yd.
LUMBER GR.
FRAMING / /�7 D
U/
ROOFING OI /� Q'j
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 4-11S'110-7
MESH
INSULATION/SOUND q12,1
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL