003184 (SATT)P.O. BOX 1504 N0. 003184
Building . 78-105 CALLE ESTADO
Address S-5—IPS Oak kill LA QUINTA, CALIFORNIA 92253
Mailing
BUILDING: TYPE CONST. OCC: GRP.
Address /75"003 !.=X9, Club Drive
A.P. Number PGA Went
City
Zip
Tel.
Desert
92260
.566-2828-
Legal Description
Description P ase 30—A Plan Plan 43 N
Contractor
. National Mortgage And I�d Project
Address
FINAL DATE
City.
Zip
Tela
State Lic.
& Cla sif..
'�`3O
L'lo # 3��
Sq. Ft. ' �$c'�9 No. No. Dw.
Size' • Gar 420 ' Stories - '- Units
New C� Add ❑ Alter ❑. Repair ❑ Demolition ❑
Arch., Engr., '
Designer
Address Tel.
City Zip State
Lic. #
- _ LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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 '
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S,Busfness 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 81e a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with.Section. 7000) or
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 the applicant to a civil penalty of not more than five hundred dollars ($500). " - • '
❑ 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 6r -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 offeredfor sale. If,. however, the building
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 of sale.)
❑ I, 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
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to 'self:lnsure, 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 th0 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: d, 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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct:
1 agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof- this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
Estimated Valuation
� 7
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I. _.
Grading
Driveway Enc.
rastructure
TOTAL
REMARKS
AMOUNT
2.000.00
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 6129;/R7 Permit
Validated.by:
Validation:
HARD COPY
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SQ. FT. Q
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. I SO. FT.
WAIL 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS(ROUGH)Ga
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
i
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE --JCONST.
FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND 44/14
Q
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR E I T
J
K
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 7 �%
P�
GAS(ROUGH)Ga
/� 7
i
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
AL INSP.
FINAL INSP. Z
GRADING
cu. yd.
$ -plus-x$_=$
LUMBER GR.
FRAMING �r r r°�
ROOFING /,, /F7/_ %
!/
i
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND f !fI1
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL