002118 (SATT)Building
Address
44
P.O. BOX 1504
78-105 CALLE ESTADO
IS Oak rftM LA QUINTA, CALIFORNIA 92253
Mailing
Address 755-005 00aftY Club Dr_
CityJZip 9Tel.
Pal* 92260568-252$
Contractor
Address.
��ev►s
City
sam
State Lic.
& Classif.. 2MI30
Arch., Engr.,
Designer
Tel.'
No.. 002118
JILDING: TYPE CONST: OCC. GRP.
P. Number
!gal Description
oject Description NM A.3 0
City Dri 16171
Lic. # Sq. Ft. QW 224 No. 1 No. Dw. 1
Size - Stories Units
New Add ❑ Alter ❑
Repair ❑
Demolition ❑
Address
Tel.
Minimum Setback Distances:
Front Setback from Center Line
CityZip
State
Lic. #
Side Setback from Property Line
LICENSED CONTRACTOR'S DECLARATION
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
effect.
FINAL DATE
INSPECTOR
Issued by:"
Date 3-0 Permit
SIGNATURE r'" X., • �' r+ a `^ ' N � DATE
#L," OWNER=BUILDER DECLARATION
. • l
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
• reason: s(Sec. 7031.5, Business and' Professions Code: Any city or county which requires a. -
- permit to construct, after, improvejdemolish, 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 of the Contractor's License Law, Chapter 9 (commencing with Section 27000) of
'Division 3 of the Business and6Professions 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
subjects the applicant to a civil penalty or not more than rive hundred dollars ($500):
❑ 1, 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
. 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,
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 did not build or improve for the purpose of sale.) -
❑ 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.)
O 1 am exempt under Sec. B. & P.C. for this reason
Estimated Valuation
-S,103,665.50.
Validation:
PERMIT-
AMOUNT
�1 !�A-
Plan Chk. Dep. 250.00
_
Plan Chk. Bal. - -
U,4.19
Const.
44 3.50
Mech.
.
34:00
Electrical
���
Plumbingw
_
S.M.1. -
'��
Grading
Driveway Enc.
Date Owner
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) - - - -
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
" Date Owher
NOTICE TO APPLICANT: If, alter making this Certificate or Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This -is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above a information is correct:
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property fdrAnspection purposes. _
t lr
Signature of applicant t��/j. '�t,li .-^- —Date–
Mailing
ate Mailing Address
City, State, Zip E 1 Z r
HARD COPY
Infrastructure 554.-$
TOTAL i .'� i 2.308.76
REMARKS AM SPA
g yIT AW #s y {
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 3-0 Permit
Validated by:
Validation:
A4565
3 6 25L 76 R
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SQ 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
tt i0t1GH PLUMB.,6
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)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM5 Z% /J/ P
�D
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING
/
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MEICH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
1 OUND PLUMBINGUNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ZIZ 1kr11
tt i0t1GH PLUMB.,6
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
f-( IbEWER OR SEPTIC TAN
rl-kGH WIRING S /�
6
DUCT WORK
ROCK STORAGE
FOUND. REINF. �Z �v �y
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL j Z'AA
GAS (FINAL)
TEMP. POLE
GROUT Z® G
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM5 Z% /J/ P
�D
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 p
MESH
LNSULATION/SOUND S
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESnNITIALS
GARDEN WALL FINAL