001850 (SATT). e
4
P.O. BOX 1504 No. 0018513
Building 54-124 Oak Tree 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Sl1nx'$IBG' Cmp8alplf -
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 710093 Country Club Drive' A.P. Number
C"Falm Desert Zip 92260 Tel. 568-2828 Legal Description
Contractor Nat'l Land .'�e9z`'tge Project Description i PLAN 4Q
' �
Address
aim
City Zlp 7Tela
Sam Sam
State Lic. City
& Classif. Lic. # 328 Sq. Ft. GM 424 No. No. Dw.
..
Size Stories 1 Units 1
Arch.-, Engr.
Designer Robert '®Revers ®ssm. New N Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
3915 Red. RJU Ave. (714) 540--5117
City Zip State
Costa He8a 912$36 Lic. #
_LICENSED CONTRACTOR'S DECLARATION
I hereby affirm,that'I am licensed under provisions of Chapter 9 (commencing with.s'ection/. '
7000) of Division 3 of.the Business and Professions Code, and my license is in full force (
1 "+3
SIGNATURE
�OWNER•BUILDER DECLARATION / ?' Estimated Valuation
I hereby affirm that Ilam exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and' Professions Code: Any city or .county which requires a $.'120.39.8.00
.
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement thathe is licensed pursuant.to PERMIT AMOUNT
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 \.i p -
for the alleged exemption. Any violation of Section 7031..5 by 'any. applicant for a permit Plan Chk. Dep\ �� 1 .
-subjects the applicant to a civil penalty of not more than five hundred dollars (8500). �9+t
q I,, as owner of the property, or my employees with wages as their sole com5
pensation, will Plan Chk. Bal. J 6
do the work, and the structure is not intended or offered for sale. (Sec. 7044, euisness and Const. k$5.59
Professions Code.,The Contractor's License Law does not apply to an owner of property, who _ " %a
builds or improves thereon and who does such work himself or through. his. own employees, Mech. - .7i9 w�
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 74.60
of proving that he did not build or improve for the purpose or sale.) -
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 5
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 S. M.1. <t
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure 1,805.97
WORKERS' COMPENSATION DECLARATION
Ihereby 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. O Certified copy is hereby furnished.
TOTAL 2.891..56
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuationPtr�E4.R' ri';E1i.�''. P43tY'1'
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 California. K= RAMS
Date Owner
NOTICE TO APPLICANT: If, after making this Certificateof Exemption you should become ZONE: BY:'
subject to the Workers' Compensation provisions :of the Labor Code,- you must forthwith Minimum Setback Distances: '
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
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.Llne
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 t
expiration it work thereunder is suspended for 180 days. 11-12 �S Permit
I certify that I 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, fepresentatives sof this city to enter thetabove-1
mentioned property for insp%ectiompurposes. f i _ „—Validated by:
Signature of applicant+T Date'—'7 s�_!r �_ 1
Mailing Address — .% Validation:
City, State, Zip J r
A3Z.11 11 13 2851.56 U
HARD COPY
L]
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEF`
NO. PLUMBING FEES
IST FL. SO. FT. ®
2ND FL SO. FT,
POR. SO. FT. ®
GAR. SO, FT. ®
CARP. SO. FT. @
WALL SO. FT.
SO. 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.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING 3 (3
GAS PIPING
PERMIT FEE
PERMIT 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
SETBACKOUND
PLUMBING �B 6
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 APP.IEOUIP.
REINF. STEEL
GAS (FINAL) 2/ f,* ,f
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
114AL INSP. -S
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FRAMING [ 11 `�
FINAL INSP.
ROOFING 3 (3
�l!/ �-��
C/
REMARKS:
VENTILATION
FIRE ZONE ROOFING -
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL