001860 (SATT)Building
Address
Owner
Mailing
Address 75
City
Palm, resert
Contractor
4rTa*-
Address
ty
State Lic.
& Classif.
'Arch., Engr.,
Designer
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Zip Tel.
92260 568-282.8
City
Lic. # 328
BUILDING: TYPE CONST
No.
OCC: GRP
A.P. Number
Legal Description
Project Description 1N 3#
Sq. Ft. 127
Size IM 42$
New &, Add ❑
No. No. Dw.
Stories Units .
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Lender's Name
BY:
. . MS, Ll Ave.
lid 540-5319
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.
Rear Setback from Rear Prop. Line
I certify that I have read this application and stale that the above
City
Zip
State
to enter the above-
Date
of applicant r
'Costm VIM
92626:
Lic. #
City, State, Zip /
r
LICENSED CONTRACTOR'S DECLARATION
Validation:
.
I 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 full force and
11 13 X55&76 CC
.effect.. f
SIGNATURE •-- / /'. "' ./ '' DATE
% OWNER -BUILDER DECLARATION /
I hereby affirm that I' am exempt from the Contractor's License Law for the following
Estimated Valuation
^
103.665.60.
� ��
reason: (Sec. 7031.5,Business and Professions Code: Any city or county -which requires a
• *' Li
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 that 'he is licensed pursuant to.
PERMIT
AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with* Section 7000) of
c
'. Division 3 of the Business and' Processions Code, or that. he is exempt therefrom, and the basis
Any Section 7031.5 'any for
Plan Chk. De p
for the alleged exemption. violation of by applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). -
.
Plan Chk. Bal.
364.19
O I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and '
Const.
�t �
dd3.50
Professions Code: The Contractor's License Law does not apply to an owner or property who
builds or improves thereon and who does such work himself or through his own employees,'Mech.
34.00
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year or completion, the owner -builder will have the burden
Electrical
67.41
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
builds improves thereon, for
- _
S.M.I.
7.18
does not apply to an owner of property who or and who contracts
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
1F55A.90
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.
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 tha 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____L'_Owner
NOTICE TO APPLICANT. Of, after making this Certificate of Exemption you should become
subject to the"Workers' •Compensation provisions or 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.)
NO BE= TSS
Lender's Name
BY:
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.
Rear Setback from Rear Prop. Line
I certify that I have read this application and stale 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
mentioned property for inspection purposes.
Signature ( % �✓
to enter the above-
Date
of applicant r
INSPECTOR
Mailing Address l
Date 11 12--8 Permit
City, State, Zip /
r
HARD COPY
TOTAL 2.558.76
REMARKS
NO BE= TSS
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 11 12--8 Permit
Validated by:
Validation:
A3Z-Ii 5
11 13 X55&76 CC
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FF
NO. PLUMBING FEES
1ST FL. SQ. FT. ®
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR, SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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
I SLAB GRADE 1
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
�^
14SEWER OR SE TI��Al �
v ii
T OUGH WIRING!
1I
DUCT WORK
ROCK STORAGE
I l (}-FOUND. REINF. F♦� I/� O S
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL /�
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
&4 NAL INSP.
j� FRAMING 7
FINAL INSP.
T 14 ROOFING ( G
/ ✓ �e h
VENTILATION
'
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
NINSULATIONISOUND
1
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE. FINAL
1 uM"J 2wumA 1 Unto/INI I IALb.
GARDEN WALL FINAL
'ii & 0 2`/ a-�