06160 (SFD)P.O. BOX 1504
Building��,�� Uzi 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Sutwise Co�Egany
Mailing
Address 426600 Cf3flk St Suite 200 x Y
City Zip Tel.
PalmDesert 92260
Contractor
Hatiana3 Mortgage U Land t
Address . same
State Lic. 288130
& Classif.
Arch., Engr.,
Designer
Address
City
No. 06160
BUILDING:. TYPE CONST. OCC: GRP.
A.P. Number P€;A tl.-sit
Legal Description
Project Description' Tract 207I7w: — Medalists
Plan 2138
Tel.:
City 298
Lic. # Sq. Ft- 5 No. No. Dw.
Size Stories - Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Tel.
Zip State
Lic: #
LICENSED CONTRACTOR'S DECLARATION
rm thatI am licensed under provisions of Chapter 9 (commencing with Section
ion 3 of the Business and'Professions Code, and my license is in full force and '
DATE
3 ,r OWNER -BUILDER DECLARATION *f
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Protessibns ,Code: Any city or county which requires a
permit to construct, after. Improve, demolish, of -repair any structure, prior to its issuance also
requires* the applicant for such permit to Me a signed statement that hes licensed pursuant to
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 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 penally 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 or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
bums or improves thereon and who does such work himself or through his own employees,
provided that'such improvements are not intended or offered for safe. O, however, the building
or improvement is sold within one year of completion, the owner- budder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 1, 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 onproves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 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 -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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars (S100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any pperson in any manner so as to become subject to the Workers' Compensation
Laws of Cali ornia_
Date Owner
NOTICE TO APPLICANT: ff, after 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
1 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.)
Lenders Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity 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
>timated valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Less Credit
TOTAL
AMOUNT
$ 554.22
681.50
60.00
p87.25
120.50
7.86
$2,513.57 3.,255.79
1,256.79
HEMARKS
�.rs. " — :+f^:�. rf ..:. " Eta l' i•dl;., 1, -. 4. 1 4Y4.1 , .a. v
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
Validated
Validatio
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
B GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT.
FORMS
R OR SEPT
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
S (ROUGH) .�
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SO. FT.
LU ER GR.
FINAL INSP.
AMING 1
URINAL
SOFT®
J� v
1'<
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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.
SO. FT. ®c
BATH TUB
FINISH GRADING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
SO.FT_GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE ICONST.
FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
NO PLUMBING Z
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
R OR SEPT
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
OUND. REINF.
S (ROUGH) .�
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
ICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LU ER GR.
FINAL INSP.
AMING 1
FINAL INSP.
ROOFINGC/'/!
J� v
1'<
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
3SULATION/SOUND l �j
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL
1