001888 (SATT)• I
P.O. BOX 1504 No :
Building 78-105 CALLE ESTADO
Address 54"'374 Oak '&W LA QUINTA, CALIFORNIA 92253
Owner
`.2 im owtmw BUILDING: TYPE CONST: OCC: GRP.
''Mailing
Address +,5,,,005 � b Wive
City UV Zip Tel.
. Wit: Deseft 92260 568--282£
Contractor
vat,1 and Nbrtgage
Address.
Sam
City. Zip' Tela
State Lic. City
& Classif. Lica# 32
Arch.; Engr.,
Designer Alter° ASSOC..
Address Tel.
. 291- X11 Ave. - 54451
A.P. Number
Legal Description
Project Description FM MT PLAW
Sq. Ft.i9. LU8 No. No. Dw.
Size • . 424 Stories, 1 Units
New 9 Add ❑ Alter ❑ Repair ❑ Demolition ❑
City
Zip
State
crmta r1 ....
9262C.
-.- LICENSED CONTRACTOR'S DECLARATION-
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 inn full fore/ee nd
effec! ..�. . e ....;i'.. .r''!, i �' .•/!/ S.e%�'L �1
_
DATE
'OWNER•BUILDER DECLARATION f . I •- .
Estimated Valuation
I hereby affirm that loam 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
L+ nig C' f �,rq '
a7T 9 •'1623. 0 .
perinit to construct.. after, improve, demolish, or repair any structure, - plot to -its issuance also.
requires the applicant for such.permit to file a signed statement that he is licensed pursuant to
- PERMIT • AMOUNT-,
the provisions oI 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--
7031.5 'any for
Plan Chk. -Dep.,'
for the alleged exemption. Any violation of Section by applicant a .permit
subjects the applicant 7o a civil penalty of not'more than five hundred dollars ($500): - .' _ "
Plan Chk. bal...5�,.t5
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. 427.00
Professions Code: The Contractor's License Law does not, apply to on owner of property who
builds or improves thereon and who does such work himself or through his own employees,
Mech.L� ftA
34
provided that such improvements are not intended or offered for sale. If, however, the .building
.0
or improvement is sold within one year of completion, the owner -builder will have the burden
Electrical 65.44
- . 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
Strutt the project. (Sec. 7044, Business and Professions Code: The Contractor's License Low.,;
does not to an owner of who builds orimproves thereon, and who contracts for..
S.M.I. • 6.83.
apply property
such projects with a contractor(s) licensed pursuant to the. Contractor's License Law.) ..
- -.
Grading
• O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure .1,464.35
WORKERS' COMPENSATION DECLARATION
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 ishereby furnished. ..
TOTAL 2,437.17
_
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS'. COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100)' valuation
2�!� R� �`` a5�7 [n tSrap
P= E. 'Qi.J SPA ��:ad81 SC.fsi':3. � MIS F'�S'�:65.'.S
- 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
AM
Laws of California.
BLOM MW
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.
MinimumSetback Distances:
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 Line
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
expiration it work thereunder is suspended for 180 days.�j
Permit '
I certify that I have read this application and state that'the above information is correct;
Iss_ ued by: Date
I agree to comply with all city and county ordinances and„state laws relating to building
r -
construction, and hereby authorize,, representatives -of-this city to enter •the above-. /
' ' '
mentioned property for inspect tion purposes;- . r
_V_�klidated by:
' Signature of applicant. ' !' . ' - .' —Date,/�cti
+ y
Mailing Address f 1•
Validation:
_
City, State, Zip
A 3 1 9 4 11 13 24.7,17 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EFjol
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
1 SLAB GRADE 1 %o'
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SD. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. ®
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
KFINAL INSP. 7 �G( �
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
SPARK ARRESTOR
SQ. FT. ® c.
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/e c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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 PLUMBIN 3
UNDERGROUND
A.C. UNIT
COLL. AREA
1 SLAB GRADE 1 %o'
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
�{BEWER OR I A
(ROUGH WIRING
DUCT WORK
ROCK STORAGE
T� 1+FOUND. REINF. 11 1 S
1
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
jI µKEINE. STEEL (�CiAS
(FINAL) `/ /��
�I
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
KFINAL INSP. 7 �G( �
l �{-FRAMING n
FINAL INSP.
{.00
1^ RFING /lf
`` `` r
VENTILATION
REMARKS:.
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
i INSULATION/SOUND 3 6
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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