001887 (SATT)W44
P.O. BOX 1504
No. .001887
Building 54-386 9, LA QUINO
Address TA, CALIFORNIA 92253
Owner _.
BUILDING: TYPE CONST. OCC: GRP:
Mailing
Address 75-005 0=ntTY Club Dri.Ve
A.P. Number
City 1Zip Tel.
Palm Desert - 92NO ®�$��$.. Legal Description
Contractor Project Description PM TOW NM 2
$ g-1 Lwd and N=bMe.
Address
"City Zip Tela"
seem Sam
State Lia City alb
& Classif. Lic. # 328 Sq. Ft. 4 No. No. Dw. i
Size Stories Units
Arch., Engr.,
Designer Mbert Alter A08W. New lft Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
2915- Rad HM Avg. (714). 1.17
City Zip State
LICENSED CONTRACTOR'S DECLARATION ,
.1 hereby affirm that°fam licensed under provisions of Chapter -9 (commencing with'Sections , '
7000) of D•vision'3 of the Business and,Professions Code, and my license is in, full fob a arfd
effect
_,.--� :ice• •:i '-S'��'.�
SIGNATURE` `: - /' - /' DATE .. _
/ OWNER.BUILDER•DECLARATION
r Estimated Valuation
I'hereby affirm thatIl�am exempt from the Contractor's License Law .for the following
reason. (Sec: 7031.5,Business andProlesions Code: Any city or county which requires a
permit to 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 be is licensed pursuant'to .. PERMIT -- - AMOUNT '
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of-
- Division 3 6/'the Business and' Professions. Code, or that: he is exempt therefrom,. and the basis
/or the - alleged exemption. Any violation of Section 7031.5 by any applicant. for a permit. Plan Chk. Dep... -
subjects the applicant to'a civil penalty o/ not more than live hundred dollars ($500).
01 Plan Chk. Bal.
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 r Const 427.€ 0
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, . Mech. . " " " " - 34.00
provided that' such improvements .are, not intended or. offered for sale. I/, however, the building
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 o/ sale:) _- w�
O 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 o/ property who -builds or improves thereon, and who contracts for : S.M.I. - - 6.83
such projects -with a contractor(s) licensed pursuant to the Contractor's License Law.) . -
Grading
0 1 am exempt under Sec. -B. & P.C. for this reason -•
Driveway Enc.
Date Owner Infrastructure 1,4664.35
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 - " -
0 Copy is filed with the city. "O Certified copy is. hereby furnished.
TOTAL 2.437.17
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE }q
(This section need not be completed if the permit is for one hundred dollars ($100) valuation 4'RYY�J WA I 1PAR t'7 7 PMW
..or less.) .. ...
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. Lis A/Vd� gi�S7 S39�
Date Owner
NOTICE TO APPLICANT. If, after making this Certificate o/ Exemption 'you 'should become ZONE: - BY:
subject to the 'Workers' Compensation provisions o/ 'the"Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked. -
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 "
Lender's Address
This is a building permit when properly filled out, signed and validated, and Is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days.'..t�C
I certify that I have read this application and state that the above information.is correct.' Issued by: Date Permit .
agree to comply with all city and county ordinances and state laws "relating to building
construction, and hereby authorize'iepresentatives of this city to enter the above
mentioned property for inspection"purposes. �f Validated by:
Signature of applicant�f Date°fir / f '-''"rte l
Mailing Address F Validation:
City, State, Zip i
f A 3 1 9 5 11 13 2437,17 C�
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EF2imk
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CARP. SQ. FT.
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
I 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. 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.
SO.FT.GAR ® 3/4c
HOUSE SEWER
1� FRAMING !1
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
TIOROUND PLUMBIC
UNDERGROUND
A.C. UNIT
COLL. AREA
TjjfSLAB GRADE '
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR S T19Tq
//
ROUGH WIRING
2
J
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
T" EINF. STEEL "I
AGAS (FINAL) I'1-7.
4` K.
t
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
-CU. yd.
$ plus x$
_ $
LUMBER GR.
gL4FINAL INSP. 5
1� FRAMING !1
FINAL INSP.
ROOFING C_ P _
VENTILATION d Y
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
/
r INSULATION/SOUND 1 231
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
Ti A. -0t2/tt f\f-c 1.1011�c