001875 (SATT)P.O. BOX 1504 NO.. U U 181 b
Building ����5 �� 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner StInrige 0051111=7
Mailing
Address 757005 Country Club Drive
Ci"P&2rt Desert 12260 Tel. 568-2328.
Contractor
ftt1WJ&1 LaUd ODA XOrtga&Z
Address
sae
City Zip Tela
Sate
State Lic. I city
& Classif. Lic. #
Arch., Engr.,
Designer Robert Altevers Asso-c.
Address Tel.
2915 Refit .HUI Ave. (714) 540-51.17.
City Zip State
Costa L40X2625 Lic. # --9a 1
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that"I am licensed under provisions of Chapter 9 (commencing'with,Section/:1
7000) of Division 3 of the Business and'Profess ions. Code, and my license is in fulliforce.and ^-
BUILDING: TYPE CONST. ':,OCC! GRP.-
A.P. Number
Legal Description
Project Description ITA MSS' Pim 10
Sq. FtDW �� ��� 1339 No. No. Dw.. '
Size Stories Units
NewIV Add ❑ Alter ❑ Repair ❑ . Demolition ❑
SIGNATURE' Z /° --DAT
OWNER -BUILDER DECLARATION' '
I hereby affirm tl5at I am exempt f from the Contractors License law for the following
reason: (Sec. 7031.S,Businesnd Professions Code: Any city or county which requires a
-� • permit to 60nsiruct, alter, improve, demolish, or repair any structure, prior to its issuance also.
requires the applicant forsuch-permit to rile a signed statement that he is licensed pursuant to
Estimated Valuation
$- 35,088.00
_ PERMIT
- - AMOUNT
the provisions -of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
" Division 3 of the Business and Pidfessions Code, or. that. he is exempt therefrom, ' and the basis
for the •alleged exemption. Any violation of Section 703 1. 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
'
- -
Plan. Chk. Dep.
.. -
Plan Chk. Bal.
Const.,
-
39140 '
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
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
Mech:
fan3
34.3
Electrical
9..Q
or improvement is sold within one year of completion; the owner-buildei will have the burden
- , 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
87.50
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. -
- - 5.99
- such projects with -a contractor(s) licensed pursuant to the Contractor's License Law:) • -
❑ I am exempt under Sec. - B. & P.C. for this reason
Grading
Driveway Enc.
Date owner
Infrastructure
�IDe8
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... O Certified copy is hereby furnished.
TOTAL
28179.42
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE -.
REMARKS.
e�ts�qq,� �' t3n�**t�a-x�ss of atm �a �ne[i nv�
POOL. JW SPA i*iC; T PARAI OF y[2,L5T s; ,Tisa a
(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 inanymanner 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
subject to'the Workers' Compensation' provisions' of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.,
, -ZONE: BY:
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
Issued by:-
�_ /=atldated by:
Validation:
A3248
INSPECTOR
g 1-125
Date Permit
,
1.1. 1. .2i 79..42 CC
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
' I`agras to comply with all city and county ordinahces and state laws relating to building `
construction, and hereby authorize representatives sof,-this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant'"
Mailing Address �t 1 : F �'J
City, State, Zip % %' �`
HARD COPY
CONSTRUCTION ESTIMATE A6.111
NO. ELECTRICAL FF2111111111k
NO. PLUMBING FEES
IST FL. SO. FT. ®
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO, FT. ®
CARP. 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
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
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
1 FRAMING
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
T" SLAB GRADE 5'
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER FC
T fFtOUGH WIRING
I
/
!�
DUCT WORK
ROCK STORAGE
1 FOUND. REINF. I �f C
I
1REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
STEEL ?^l Ll
AS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
fjZFINAL INSP. h �,
rrv-
1 FRAMING
FINAL INSP.
�9
11 1 ` ROOFING ( 7i S/�
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
Tt LATHING
MESH
,t INSULATION/SOUND Gr fi
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
;FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
Tl rt UP -( wra%,V litr q"yw