002110 (SATT)4
P.O. BOX 1504 No. 002110
Building W-381 Oak TZW78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
sunrim
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 75-0 • Courtxv Cl.Ub Dr. A.P. Number
CityZip Tel.
Palm J99260 56$-2828 - Legal Description PrA WWT• PLM 2 0
Contractor Project Description
Martsram Paid Tarm
_
Address.
.. City Zip .. Tela
Sam Sam
State Lic. City °
& Classif. Lic. # S Ft. GM No. No. Dw.
288130 �
Size. ��� Stories g Units
Arch., Engr.,
Designer New 0Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION y
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.
. j
E• .
SIGNATUR%• a+ N �' h'�-' i/ `" ,N t,.yw_ DATE -
' f r"OWNER-BUILDER DECLARATION'
I heieby,affirm that I am exempt4rom the Contractor's License Law for the following Estimated Valuation b Ari G9
reason - '(S46. 7031.5,Business and Professions Code: Any city or county which requires a - l al .�' 23.0€.f
pemift to construct, alter, Improve, demolish, or repair'any structure, prior to its issuance also 'AMOUNT
requires the.applicant for such permii to file a signed statement that he•Is licensed pursuant to - PERMIT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of .•r
Divisioil'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. - 25000
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 Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Cion St. � 427.00
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 throughhis own employees, Mech. �s �y/�
provided that such improvements are, not intended or offered for sale. If, however, the building. 34.00
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical �'� .��
of proving that he did not build or improve for the purpose of sale.) , - .
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 87.50
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's -License Law - -
doesmot apply to an owner of property who builds or improves thereon, and who contracts for S.M,j,
0.83
such projects -with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I. am exempt under.Sec. B. & P.C. for this reason
Driveway Enc. t Ar
Date 1
- Owner Infrastructure ,484.3§
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 2.,437.17 1 2187.17
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE. 7��7ht� E*[S7C q�y s w
(This section need not be completed if the permit is for one hundred dollars ($100) valuation - MIX AM MI �L'11,L. CF WS VMIMT
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' Owner
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you. should become ZONE: BY:
subject to 'the Workers' Compensation provisions- of the Labor Code, you .must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
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.DATE 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. r
I certify that I have read this application and state'that the above information is correct. Issued by: Date Permit
.I agree to comply with all city and county ordinances and state laws relating to building
C
onstruction, and hereby authorize representatives sof this city to enter the above-
mentioned property for Inspection purposes. ' r Validated by:
Signature of applicant X L f � !A, f. Dates �r ,(
Mailing Address f7 r +fir Validation:
City, State, Zip
A 4 5 7 6 3 6 2a 81,17 it
. ' HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. 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
$' TOUGH PLUMB. �yf
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 BEAM f l�
SQ. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
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 tj J/
h ROUND PLUMBING :/
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3 �y(`
$' TOUGH PLUMB. �yf
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPMN&r
lekROUGH WIRING
f1�`
S 1J6
ll
DUCT WORK
ROCK STORAGE
FOUND. REINF.
6�1��r/C
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL 512,
GAS (FINAL)
TEMP. POLE
GROUT f �6 ��
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM f l�
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING G/t� /�j�
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
k INSULATIONISOUND S t p6
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE&INITIALS.
GARDEN WALL FINAL
JJr2Yq'�ii