001879 (SATT)4
P.O. BOX 1504
Building
Address 54-180 Oak TrLA QUINTA, CALIFORNIA 92253
Owner e^a3xnt"Im Company
Mailing
Address 75-005 Country Club Drive
City Zip Tel.
Falm.ilearst ".92260 568-2828
Contractor
HatSi3n—al Land and mortgage
Address
City - Zip Tel.' '
Same 8 $am
State Lic. City 325
& Classif.. Lic. #
Arch., Engr., H6'bert Altevara
Designer
Address -2915 Md Hill Avenue TIM) 5,40-5117
City Zip State
e-9W 0;26 Lica#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm rthat I am licensed under provisions of Chapter 9 (commencing with Section'
7000) of Division 3.of the Business'anq Professions Code, and'my license is in full force and
...
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SIGNATURE _F f .t DATE _
OWNER -BUILDER DECLARATION
.1 hereby affirm that I am 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, -
permit "lo 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
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 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 tfie 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
builds or improves thereon and who does such work himself or through his own employees,
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 .
or 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-
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.)
.0.I am exempt under Sec. B. & P.C. for this reason
Date Owner
"w
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 if the permit is for one hundred dollars ($100) valuation
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 subject to the Workers' Compensation
Laws of California.
Date ' Owner
NOTICE TO APPLICANT: 9, 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
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 if work thereunder is suspended for 180 days.
I certify 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. l
Signature of applicant .- _ Date d
Mailing Address
City, State, Zip
HARD COPY
No. 001979
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
PCA WEST P IQ
Project Description
Sq. Ft. GAS 624 No.
-Size -Stories
No. Dw.
Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
P
Estimated Valuation 855=088.
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
324.94
Const.
391."W
Mech. . ..
34.00
Electrical
59."
Plumbing
87.50
S.M.I.
5.99
Grading
Driveway Enc.
Infrastructure
1,,276.00
TOTAL
2,179.42
REMARKS
PA i7. AVO "T A NOT P= OF THIS PMN
un iiitlfil WALLS
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}APermit
Validated by:
Validation:
A325L 11 13. i.� %9,42 Cts
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FE
NO. PLUMBING FEES
1ST FL. SO. FT. @
2N0 FL. SO. FT.
FOR. SO. FT. @
GAR. SO. FT. @
CAR P. 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
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
ROUGH PLUMB.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
DUCT WORK
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
TEMP. POLE
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
WATER HEATER
SO.FT.GAR @ 3/ac
HOUSE SEWER
FINAL INSP.
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
SETBACK
f�ittGROUND PLUMBING
&
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI AWM�
OUGH WIRING
B�
DUCT WORK
ROCK STORAGE
NFOUND. REINF. �t7
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
'.{ AS (FINAL) y j
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$ _
LUMBER GR.
AL INSP. S Z
J
't 7 FRAMING ' �6
FINAL INSP.
-( ROOFING 3 %�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND Iq
FINISH GRADING 444
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INsrrc i UK'b -WUNA i UnrbliNI i GALS,
GARDEN WALL FINAL