002119 (SATT)Building
Address
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address 75-005 Cin 1 C311h
CityZip Tel.
lI �t 9226thf3--242
Contractor
ivhtl Itift9ace and
Address
City lZip Tela
No. 002119
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description VIQ W .PW3 0 R
State Lic.
& Classif. 288330
City
Lic. # M
DIM 1627
Sq. Ft.
Size
No. No. Dw.
Stories I Units 1 '
-
Arch., Engr.,
Designer
NeWIF Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Lender's Name
Lender's Address
City
Zip
State
Lic. #
y
• LICENSED CONTRACTOR'S DECLARATION
I hereby,.affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70 OO) of Division 3 -of the Business and Professions Code, and my license is in full force and
effect. �\ V.. /'-, l i Mj .. ..w4 _ �-
e
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�" cliff
I certify that I have read this application and state that the above information is correct.
Issued by:
SIGNATURE' I �/ a DATE
/ `OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt ,from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code:. Any city or_ county which , requires a
permit to construct, atter, 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 of the Contractor's; License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or thathe 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 of not more than five hundred dollars ($500).
❑ 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
Professions Code: The Contractor's License Law does not apply Jo 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-
• strucl 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 contractors) licensed pursuant to the Contractor's License, Law.)
❑ I am exempt under Sec. �B. & P.C. for this reason
Estimated Valuation
- PERMIT
AMOUNT
Dep...
plan Chk. De
25A). 0J)
Plan Chk. B61.,
114.19
Const.
' < 50
Mech.
n
U -no
Electrical
_d
Plumbing'��
.
S. M.1.
`�
Grading
3 6 23 76 it
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
2. 559. 715 2i,30M6
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed if the permit is -for -one hundred dollars ($100) valuation pitl
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
comply with such provisions or this permit shall be deemed revoked. i Minimum Setback Distances:
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.
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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
construction, and' hereby authorize representatives -of this city to enter the above.
mentioned property for inspection purposes. +
Validated by:
~,
Signature of applicants Date
Mailing Address 7 r`.' ";
Validation:
City, State, Zip
%
A 4 5 6 5
3 6 23 76 it
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROU,?t PLUMB. S/y/
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
GAS (ROUGH)
DRINKING FOUNTAIN
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ®c
BATH TUB
FIRE ZONE ROOFING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEEPERMIT
LATHING .5h
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
SETBACKA�6 ��
GR UND PLUMBING /
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �L �6
ROU,?t PLUMB. S/y/
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SE. OR S T
RO WIRING S /
�6
DUCT WORK
ROCK STORAGE
FOUND. REINF. 3 y f
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL f�G /
GAS (FINAL)
TEMP. POLE
GROUT 5 �G
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM 17 ��
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
i6 �
FRAMING fAllX,05-
lJ/_
FINAL INSP.
ROOFING 6 y /�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING .5h
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL