001938 (SATT)4
P.O. BOX 1504 NG. 001938
Building 78-105 CALLE ESTADO
Address 55— 590 CA ` t' LA QUINTA, CALIFORNIA 92253
Owner
Mailing
' BUILDING: TYPE CONST. VN OCC. GRP.'
Address 75'-W5 COClUy
A.P. Number -
City Zip Tel.
.Palm Dauirt 92260 568-2828 Legal Description
Contractor Project Description S•+�•�'
Address .
City p Zip Tela e
State Lic. City DM
& Classif. Lic. # 329 Sq. Ft. X577 No. No. Dw.
Size •Stories Units 1
Arch., Engr., � -
Designer ,lam ASS=. New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
. 2915 xed. HM Me.. (714) 540-SU7
CityZip State
tit= .. 92626 Lic. #
_ LICENSED CONTRACTOR'S DECLARATION
I herebyy affirm that I am licensed under provisions of Chapter 9'(commencing with Sectidn
7000) of,,Dlvision 3 of the Business and Professions Code, and my license is in full force=and ..r
effect / ..r' " 1.
SIGNATURE .f .I" , DATE
OWNER -BUILDER DECLARATION
I hereby affirm that l amtexempt from the Contractor's License Law for the following Estimated Valuation
reason: (Sec. 7031.5,Business and Professions Code_: Any,city or county which requires a 161#730.00
-
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to frle.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
Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis ...
for the alleged exemption. Any violation of Section 7031.5- by 'any applicant for a permit Plan Chk. Dep. �t
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 g
Plan Chk. Bal. a�97*
do the work; and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who .598.00
builds or improves thereon and who does such work himself or through his ownemployees, Mech. �+
provided that such improvements are not intended or offered for sale. If, however, the building
00
or improvement is.sold within one year of completion, the owner -builder will have the burden Electrical 11-4.016of 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
struct the project. (Sec. 7044, Business and Profession's 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. 11.24 .
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0-1 am exempt under Sec..B. B. & P.C. for this reason
Driveway Enc.
Date - Owner Infrastructure 2,006+00
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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 3 394.9
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation _
or less.) �;j�„�615 . ALI �T'Xi WI Alar i
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, alter 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
Lender's Address
FINAL GATE
INSPECTOR
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.
t �__`S��
I certify that I have read this application and state that the above information is correct.
Issued by:
Date SAGPermit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize. representatives -of this city to enter the above-
mentioned property for inspection purposes.-'
., Validated by:
�r^
� � � '
Signature of applicant .�i - ..✓ Datef+'I Jf • �
Mailing Address l I _ /'
Validation:
City, State, Zip fJF
A3527
12 10 3394,55 R
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL rsi6k
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. Q
POR. SO. FT. ®
GAR. SQ. FT. ®
CARP. SO. FT.
WALL SO. FT.
SO. 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
EONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS /
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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 If 3 (p
ROUGH PLUMB.
EONDING
HEATING (ROUGH)
STORAGE TANK
FORMS /
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
/FINISH GRADING
' FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL