002102 (SATT)P.O. BOX 1504 N o .
Building 78-105 CALLE ESTADO
Address $ 357. Oak Italia LA QUINTA, CALIFORNIA 92253
Owner
Mailing aa.u.a+r ie s:b: v.rLcrhdrt
BUILDING: TYPE CONST: OCC: GRP.
Address
A.P. Number
City744p
7PT14I.
v-...
Legal Description
Project Description
Contrator cpro gee.,
. � elan n
Address
'. City ...
Zip
TO:
State Lic. '"
& Classif.
City
Lic. #
Sq. Ft. JXM' Mo
No. No. Dw.
ae,t
-
Size +'arta 't.9
Stories 9' Units
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Arch., Engr., . ,�„"""" . ' .scat `
-
.�
Designer i
New ❑ Add❑
Alter ❑y Repair ❑ Demolition ❑
Address
Tel.
6
City
Zip
State
Lic:.#
LICENSED CONTRACTOR'S DECLARATION
r
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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
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SIGNATURE .i'. It DATE
'' iOWNER•BUILDER DECLARATION
,t —
I hereby affirmthat I am exempt from the Contractor's License Law for the following
.. , reason: (Sec.. 7031. 5, Business and Professions Coder -Any city. or 'county which requires a
Estimated Valuation
- '
�+►- '.A.
-- -
PERMIT
,
0 0v rJovu,
AMOUNT '
permit to construct, after, improve, demolish, or repair an.y structure, prior to its.fssuance also
requires the applicant for such permit to�file a signedstatement that he is licensed -pursuant to
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the BusinessandProfessions Code, or that .'he is exempt therefrom, and the 'basis -
for the alleged exemption. Any. violation of Section 703.1.5 by any 'applicant for a permit
• Plan Chk. Dep..
-
- -
"subjects the applicant.to-a-civil penalty of not more than five hundred dollars ($500).
❑ 1, as, owner.of the property, or my _employees with wages as their sole compensation, will
PIan.Chk, Bal.
Const. f
Io
iio the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an, owner of property - who
M@CII'.
_
builds or improves' thereon and who does such work himself or through his own employees,
., 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
• of proving that he old, not build or improve for the purpose of sale.) .:
❑ .I, as owner of the property, am exclusively contracting with licensed contractors to con-
Electrical
-
Plumbing
'fie
- struot-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
• -such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)!"
13.1 am -exempt under Sec. B.-& P.C. for. this reason
S.M.I.
-Cif s
Grading
-
Driveway Enc.
..
Date owner
Infrastructure
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.
TOTAL
CERTIFICATE OFE XEMPTION FRO M
WORKERS' COMPENSATION INSURANCE
REMARKS
- (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' Compensation1l:
Laws of California.
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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 rhust forthwith
comply with such provisions or this permit shall be deemed revoked. -
_ZONE: BY.:
Minimum Setback Distances: -
Front Setback•f.rom Center. Line
'
Rear Setback from Rear Prop.. Line
CONSTRUCTION LENDING AGENCY
hereby affirm that there is a construction lending agency forthe performance of the '
work for which this permit is issued. (Sec, 3097, Civil Code.)
Side Street Setback'.from Center Line
'
Side Setback from Property Line
Lender's Name
FINAL DATE
INSPECTOR'
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 io'building
construction, and hereby authorize representatives of this city to enter the `above-.
mentioned property for inspection purposes. •- t
Signature of applicant '] �•- � .. �I a Date r ' /_!
Mailing Address ; f• a �.f/r. -¢ T
-issued by:
Validated by:
Validation:
A 4 5 8 0
Date -* ... Permit
3. 6 929,42 it
City, State, Zip
t�•f HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES in,
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE 3/� �Fj H
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. Q. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT S
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
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
LATHING
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 j �� f' /�
GRA PLUMBING ! lZI'°
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3/� �Fj H
�&IOUGH PLUMB. �j Q6
v
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS/
SEWER O SEPTIC T d
(ZY9t1GH WIRING �/i/
DUCT WORK
ROCK STORAGE
2
FOUND. REINF. / �2 p� �i�
(/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL C �7 2�
GAS (FINAL)
TEMP. POLE
GROUT S
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM 517- -7 e4
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING o� Q
v
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
c�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
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