002117 (SATT)44
P.O. BOX 1504 No, 002117
Building 78-105 CALLE ESTADO
Address W-369 0& Mme LA QUINTA, CALIFORNIA 92253
Owner
Mailing_
BUILDING: TYPE -CONST. OCC: GRP.
Address
A.P.'Number
City
Zip
Tel.
•Palm DaSeft
92260
56$*-2$�$ - .
Legal Description
Project Description
TM Tcpc" • WA VIV 14 em
_
Contractor
I"-4Ngland
Address.. . .
Sam
::City.
Zip
Tel.. ...
State Lic.
& Classif. 2€ 8130
City
Lic. # 328
UM 1627
Sq. Ft.
Size XM 424..
No. No. Dw.
•Stories I Units
- Arch., Engr _ ... _ .
Designer
New 1@ • Add 0
A
Alter ❑ Repair'D' Demolition p
Address
Tel.
City
Zip
State _
,..
Lic.'# . ._
LICENSED CONTRACTOR'S DECLARATION
"
a•
I hereby affirm that Ijam licensed under provisions of Chapter 9 (commencing with Section
7000) of'Divisionl3 of T the Business and Professions Code, and my license is'in full force and
i effect.• j' a _A, C"/
.. ....
.. .. .. .. ..
•
SIGNATURE- 7 Ll:.,e - na yr_%. -t:.. .} '"' r DATE
a
fd "
. tr'OWNEWBUILDER DECLARATION '
E d
that I am exempt'6e s the Contractors License Law for the following
I , : (,Sec.
reason: (Sec. 7031.5,Business and Professions Code: Any city. or county which requGes:a
cr permih to construct, altei, improve, demolish, or repair any structure, prior to its issuance also
- •^requires the applicant for such permit) -to file a signed statement 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 Business and Piofes§ions Code, or that. he is exempt therefrom, -'arid the -basis
for the alleged exemption. Anyrrbiolation of Section 7031.5. by any applicant for a' permit,
subjects the applicant to a civil penalty or not more than five hundred dollars ($500). '•
O'.I, as owner of the property, or my employees with wages as their sole compensation, will
Estimated Valuation
-
1. .r T9 e:>�r
V1034665.50 1€ 3 66 50
y PERMIT
-
-
. -. AMOUNT '
,-
.� Plan Chk. Dep.
250..€ 0
Plan Chk. Bal..
-
1.4.19
Const_'.
- do 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
•builds or improves thereon and who does such work himself or through his own employees,'
m
,provided that' such improvements are.not Intended or. -offered, for sale. It, however,.the building
'Mech.
..,'
-&t'{� .
Electrical -
� � ,, '
• or improvement is sold within one year of completion, the owner -builder, will have the burden
' of proving that he dr'd not build or improve for the purpose of sale.) , ', - ..
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
- 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
-• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) . .
❑ I am exempt under Sec..'B. 8 P.C. for this reason
'
Plumbing
-•
87.50
S•M.1.
- 718 +
Grading
.•. I
Driveway Enc.
- Date Owner
Infrastructure
i t;MA no
WORKERS' COMPENSATION DECLARATION
' 1 hereby affirm' that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ora certified copy.thereof. (Sec. 3800, Labor Code.)
`Policy No. Company
❑ Copy is filed with the city. O Certified.copy is hereby furnished.
TOTAL
2,558-.76 2,309.76
CERTIFICATE OF EXEMPTION FROM
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" Compensation
Laws of California.
, .
TWL AS.M. PMW (7 WS rmw
'
'Date____Owner
_ NOTICE TO APPLICANT. If, ager making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions' or the Labor Code: you must forthwith
-comply with such provisions or this permit shall be deemed revoked. -
,ZONE: BY:
Minimum Setback Distances: -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
• 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.)'
Side Street Setback from Center,Llne
Side Setback from,Property Line
Lender's Name
Lender's Address
FINAL DATE
Issued by:
Validated. by:
INSPECTOR
Date3"'5-86Permit
F
' - 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.
11agree 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 fori�inspection purppo,ss�ds F _
Signature of applicant r A dxe+ I/' {i! f dam+ »A Date•- _ ) f%
Mailing Address r_%
Validation:
A 4565
_ .
3 6•. 13.0 7-6 R _ .
' City, State, Zip
�' ' HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT.
SO 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
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
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
GAS PIPING
PERMIT FEEPT
EE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
ME3H.FEE PL.CK.FEENST.
FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK 3 �/ /%�
�'GGROUND PLUMBING NIZ
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
WOUGH PLUMB. S 1�/f14
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR PTI K//y
ROUGH WIRIN S' ,,IA
DUCT WORK
ROCK STORAGE
FOUND. REINF. r�
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL f 7 7/� ��
GAS (FINAL)
TEMP. POLE
GROUT 5,t2 wA
1016
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAMS Z 71 2/J_
WATER SYSTEM
GRADING
cu. yd.
$ plus X$
_$
LUMBER GR.
FINAL INSP.
FRAMING S iy 2/L
FINAL INSP.
ROOFING 61611
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING yj/B6 2�G
MESH
2 (L INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREShNITIALS
GARDEN WALL FINAL
✓t2V'u/�/ s//9� ��