003187 (SATT)P.O. BOX 1504 No. 003187
Building 78-105 CALLE ESTADO
Address 55-045 Oak Hail LA QUINTA, CALIFORNIA 92253
Owner
Swrize BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 7r.—Anc; mtv-" 101"% rfr$wra A.P. Number Wf2A "..,^a.
City Zip Tel. w
ftlu lett 9$264 56£-2828- Legal Description
Contractor Project Description Ph&w 30—.x. Plan 3
Address
9
City Zip Tela
State Lic. City
& Classif. Lic. # 3�� Sq. Ft. � 1627 No. No. Dw.
. .
Size 4 1i -Stories Units
Arch.; Engr:,
.Designer New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
Address Tel.
City Zip State
Lic. #-
_ LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter (commencing with;Section
7000) of Division 3 of the Business and Professions Code, and my license, is in full ,force and
effect. , .r...
SIGNATURE 'DATE
OWNER -BUILDER DECLARATION
Estimated Valuation .
I hereby affirm that I am exempt from the Contractor's License Law for the following $113s727o00
reason: (Sec. 7031.5, Business and Pro/essions Code
: Any
City
or county which requires 'a
perm
ltato,'construct, alter,- improve, demolish, or repair any structure,
prior to i's
issuance also - -
ie'quires,`dhe applicant to'
such permit to file
a signed statement that he is license
d pursuant to - PERMIT - ' - AMOUNT
. the provisions. o1 the Contractor's License Law, Chapter 9 (commencing with Secfiom 7000) of. '
Division 3"o, -Business and Professions Code, or that he is exempt therefrom, and the basis
/or'ffre alleged .exemption. Any violation o/ Section 7031.5 .by 'any applicant for a permit Plan Chk. Dep.
-
sLbjects:the:appiicanf to a civil penalty of not more than live hundred dollars ($500). -
0-,1, as,owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.. `
do the work, and the structure is not 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 suchworkhimself or through his own employees, 'Mech.
provided that' such, improvements are not intended or offered /or sale. If, however, the building 124
or Improvement is sold within one year of completion, the. owner -builder will have the burden Electrical. V
of proving that he did not build or improve for the purpose o/ sale.). ^��Al
0 1, as owner of the property, am exclusively contracting with licensed contractors to con- 'Plumbing CSR
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an.owner o/ 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
0 1 am exempt.underSec. B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure , 7fllq 40i
WORKERS' COMPENSATION DECLARATION
Thereby 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
0 Copy is filed with the city. OC ertified copy is hereby furnished.
TOTAL Cq,. 41 y
CERTIFICATE OF EXEMPTION FROM ` REMARKS r
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is /or one hundred dollars ($100) valuation EiCrt`LcY�iT7iT.S`t'y _�''9'74'b 'i4 -j
or less.) .. ,. r _... .. .......... .. ,.. - _ .., _ �_
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 o/ Exemption you should become
ZONE:
BY:
subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
Front Setback.f.rom Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback.from Center Line
hereby affirm that there is a construction lending agency forthe-performanceof 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. -
Issued by:
Date r t3 '!C IPP Permit -
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.
Valldated.by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
�-, > ,. •;:.
i N0.-: :'? ELECTRICAL FEES
N0. 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 $
COLL. AREA
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
HEATING (ROUGH)
FLOOR DRAIN
MECHANICAL FEES
SEWER OR SEPTI TA
ROUGH WIRING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
ROCK STORAGE
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
HEATING (FINAL)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR — SUSPENDED
GAS (FINAL)
TEMP. POLE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GROUT
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
WATER SYSTEM
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
_$
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
FINAL INSP. _ // (/
SQ. FT. @ c
BATH TUB
SQ. FT. @ c,
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
VENTILATION
SQ. FT. RESID @ 11A c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
-
FIREPLACE
GAS PIPING
PERMIT FEE -
PERMJT.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 PLUM I G
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.7]
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI TA
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.7 �7
GAS (ROUGH) �V ��
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$
—'plus—x$—=$
_$
LUMBER GR.
FINAL INSP. //Al
FRAMING ' /.t�D
";7107
FINAL INSP. _ // (/
ROOFING q G) 017
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND G% �
FINISH GRADING t
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
•
GARDEN WALL FINAL