001992 (RPL)Building 54-2N
Address
Oak TZW;
Owner
a.
wIlrise
Mailing
Address 7,J"00J CaY1try Club ttlVe
City Zip Tel.
Pau-, nwmrt J. . 92260
Contractor
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 00.992
BUILDING' TYPE CONST. OCC. GRP.
A.P..Number
Legal Description
PM We a
Project Description
. City
SMW
Zip
Sam
Tela _. _
saw
..
State Lic.
City
& Classif. . _
Lic. #
Sq. Ft.
No. No. Dw.
•
Size-
Stories Units
Arch.; Engr.,
Designer
Newt Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
_
Lic. #
1 VAP' c y
LICENSED CONTRACTOR'S DECLARATION
'
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000'i of Division 3 of the Business and Professions Code; and my license is in fulfforce and
effect.
DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following .
Estimated ValuatlOfl .
reason: (Sec. 7031.5,Business and Professions Code: Any city or„county which ,requires a ..
permit to construct, after, 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•r ..
AMOUNT
the provisions of the Contractor's License Law, Chapter. 9 (commencing with Section 7000) of -
Plan- Chk. Dep.
- -
-
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): ” CI 1, I, as owner of the property, or my employees with wages as their'sole compensation, will
Plan Chk:. Bal.
Const.
-
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
Mech.
,
.
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
. of proving that he did not build or improve for the purpose of sale.) ...
Electrical,
Plumbing
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 improves thereon, and .who contracts for
S.M.I. -
-
-
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
-
Grading
Driveway Enc.
Date Owner
Infrastructure
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
O Copy is filed with the city. ❑ Certified copy is hereby furnished.. .
TOTAL
35.00
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(This section need not be completed if the permit is for' one hundred 'dollars (S 100) valuation
or less:)
I certify that in the performance of lhg 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
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.)
Side Setback from Property Line '
Lender's Name
FINAL DATE
INSPECTOR
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.
A. 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. . f
Issued by:
Validated by:
Date Permit
.:_ �s".
Signature of applicant' :Date •
. Mailing Address
Validation:
A 3 7 8 2
1 9 SACC C�,
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. � SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. ® c
BATH TUB
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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
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 APP./EQUIP.
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
IUM"J WUNA1 UKLWIN II IALb.
GARDEN WALL FINAL