001891 (SATT)4
P.O. BOX 1504 No. 001891
Building78-105 CALLE ESTADO
Address 56—U6 Oak Tree LA QUINTA, CALIFORNIA 92253
Owner
3� BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 75-005 (Mb A.P. Number
City Zip Tel.
Palm DEseft 92260 Legal Description
Contractor Project Description TIM oxqp W-Aw 2m
tli Land and V se
..Address....
City Zip Tel..
>�saw SEM
State Lic. City B48
& Classif. Lic. # 329 Sq. Ft. No. No. Dw.
Arch., Engr:,
Size - Stories - • ..Units
Designer. ertc�'ltord-re 1 � New ® Add O Alter 0. '. Repair O Demolition
Addressyy Tel.. a �q 9 q
... . . _. 2915 :�. Jhlc .D. • 714) 540r5117
City Zip State
Cb�� -92626........ Lic: #.,.
LICENSED CONTRACTOR'S DECLARATION
1 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,fGII for/c,,e,�!,�and' "•
SIGNATURE /' DATE
OW14ER•BUILOER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation 9; 62,00
. reason:._(Sec. 7031. 5, Business .and Professions Code: Any city or county which' requires a. f �4
' 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 (commericing.with Section :7000). of
Division 3 of th'e`•Business and Professions Code, or tha:
t. he is'exempt therefrom,and the basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit. Plan Chk:•De'p�..
.subjects the applicant to -a civil penalty'of not more than live hundred' dollars ($500). -
❑ I, as owner of the property, or my employees with wages as their sole. compensation, will • Plan Chk. Ra 1.
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 such work himself.or through his own employees, Mech. -sw
. • 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 Electrical6544'
...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- Plumbing $3750
s
strucl the project. (Sec. 7044, Business and Professions Coder 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. - 5.63
such projects with a contractor(s) 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 1A64,35
WORKERS' COMPENSATION DECLARATION
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 .
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 2:.437.17
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE �)) �a� ��9'�e i�r f f�,
(This section need not be completed if the permit is for one hundred -dollars ($100) valuation KDl+.'96!' AM iazirs licl6 PAW eta~ "MM PMW.
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 subjectAo the Workers' Compensation NO X=
µ
Laws of California. car
Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become ZONE: BY:
subject to the' Workers' Compensation provisions of the Labor Code. you must forthwith Minimum Setback'DlStanceS: -
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center.Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
I hereby affirm that there is s 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 �y�s
expiration it work thereunder is suspended for 180 days. �is12--s
1 certify that I have read this application and state that the above information is correct.. Issued -by: Date Permit
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. f _ Validated by:
Signature of applicant, r %' "�i Date"z
Mailing Address 1 W. �� Validation:
City" ,State, Zip ' t'
% A320 11 13 i4 17 Cf.
HARD COPY =
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FE &k
NO. PLUMBING FEES
IST FL. SQ. FT. ® $•
2ND FL. SQ. FT.
FOR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING
Y/ 340
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE MECH.FEE
PL.CK.FEE
CONST. FEE ELECT. FEESMI
FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
�/4ROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING �j fy
G�
DUCT
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
i
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
INAL INSP. � �v
GRADING
cu. yd.
$ -Plus-X$-=$-
lusx$_$ROOFING
LUMBER GR.
FRAMING (� ®� t(
FINAL INSP.
ROOFING
Y/ 340
/ ' //
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL