003147 (SATT)Building
Address 55-355 Oak Hill
Mailing
Address 75-005 Count
City lZip
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Contractor
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Address.
City ' .
Zip
Zip
Tel. "
State Lic.
Lic'#
City
& Classif.
Lic. #
Arch., Engr.,
Designer
4
P.O. BOX 1504 No. 003147
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
-BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
-2828 Legal Description
Project Description Pbalse :5C - Plate tOO C
Sq. Ft.
Size
New EX
3478 No.
GAR 696 • Stories
No. Dw.
Units
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 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code; and my license'is in'full force and
effect77.
- -
SIGNATURE DATE-
' OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
Estimated Valuation
�f y l.q�qq /�
31
reason: (Sec. 7031: 5,Business and Professions Code: Any city or county which requires a
L 9 V.dII7 e�i�
- permit ,to construct, alter, impiove, demolish, or repair any structure, prior to its issuance also
requires the applicant forsuch permit to file a signed statement that he•is licensedpursuant to
PERMIT
-
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3'of*the. Busines's and Professions Code, or. thathe is. exempt therefrom,and'the basis
for the ' Any Section 7031.5 by 'any for
.plan Ghk. De p
.
t�S�y
5250
alleged exemption. violation of applicant a permit
subjects the applicant to a civil penalty of not more than five,hundred dollars ($500).
Plan Chk. Bal.
o f00
.. O 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
Const.
e5
711.(0.
Professions Code: The Contractor's License Law does not. apply (o, an owner.,of property who
-
builds or improves thereon and who does such work himself or through his own employees,'.Mech..
59.i
. 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
140...71
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
144.50
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 contractors) licensed pursuant to the Contractor's License Law.) -
-
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason "
Driveway Enc.
Date owner
Infrastructure
2 ®'S#'.00
WORKERS' COMPENSATION DECLARATION
Ihereby affirm Ahat 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 Nb. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL_6tA�_i
8.fat5,f32
CERTIFICATE OF EXEMPTION FROM
REMARKS
'��
-..WORKERS! COMPENSATION INSURANCE "
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
t�
s(1e 'fi �i'7h ;40 ':6 ��a�,
• 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
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
AP /91 '- Permit
certify that 1 have read this application and state that the above information is correct.
Issued by:
Date
I 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.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBLTOTAL
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
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL