001935 (SATT)• I
I�
I I#4
P.O. BOX 1504
Building78-105 CALLE ESTADO
Address 55-'658 Cak MM LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 75-045 CX=try Club DrivI~
City Zip Tel.
Palm Desen . 922601 568-2828
Contractor
.. Mel N gaCie and Land
Address
City lZip Tel.
ft I a 1 N
No. 001935
BUILDING: TYPE CONST. VN OCC. GRP. P+1
A.P. Number
Legal Description
Project Description
State Lic.
City
EW2 3JAZ
& Classif.
Lic. # 37A
Ft. CM 589
No. No. Dw.
Side Street Setback from Center Line
Size
Size •
Stories Units 0
Arch., Engr:,
INSPECTOR
Issued by:
Designer 'ice Alm A==41
New I. Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
A 3 5 3 7
291.5 Fed Hill Me
(714) S40-51:37
City
Zip
State
fC A Pwsa
1 92626
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section's
7000) of Division 3 of the Business and Professions Code, and my license is in ful/Pforce:and
{
,SIGNATURE --DATE
,.
f OWNER -BUILDER DECLARATION
I hereby affirm'that I am exempt from the Contractor's License Law for the following
Estimated Valuation
197,349.00
reason: (Sec. 7031.5,8usiness' and Professions Code: Any city or county which requires a
•to
permit to construct, alter, improve, demolish, or repair •any structure, prior its issuance also
requires the applicant for such permit to file 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 that. he 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.
_
.
subjects the applicant to a civil penalty or not more than five hundred dollars'($500). -
Plan Chk. Bal.
�C, A
❑ 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
CpnSt.
+"w1
� AA
M.00
Professions Code: The Contractor's License Law does not apply to an owner of property who
�i IP s V0
builds or improves thereon and who does such work himself or through his own employees,
Mech.
��
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
Electrical
= w
-
of proving that he did not build or,improve for the purpose of sale.) - -
J.bS�w:7
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
140.50
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.
_
13.83
such projects with a contractor(s) licensed pursuant to the Contractor's -License Law.)
Grading
❑ I am.exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
2,000.00
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have acertificate of consent to seWinsure, 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. .
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 the 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, 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.
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.)
Lender's Name
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.
I certify that I have read this application and state 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 to enter the above=
mentioned property for inspection purposes.
r -
Signature of applicant .� �L Date �%w
Mailing Address
City, State, Zip y ,'•
HARD COPY
TOTAL 3,580.17
REMARKS
' M T.4q AIM SPAS AM PAW QP WTS PMUT
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-12—M-85Permit
_V. lidated by:
Validation:
A 3 5 3 7
12 "10 358L) 17 R
CONSTRUCTION ESTIMATE Amk
NO. ELECTRICAL EFAEk
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SO. FT. @
POR. SO. FT. @
GAR. SO. FT. @
CARP. SO. FT. @
WALL S0. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS jjqj3&
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
METER LOOP
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REINF. STEEL
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..
S0. FT. @ c
BATH TUB
_$
S0. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
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
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS jjqj3&
SEWER OR SEPTIC TAN{
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
INSULATION/SOUND
FINISH GRADING.
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL