002104 (SATT)P.O. BOX 1504 No. 402.04
Building 78-105 CALLE ESTAD.O
Address $0-4. Oak TM LA QUINTA, CALIFORNIA 92253
Owner
'
' BUILDING, TYPE CONST. OCC: GRP.
Mailing
Address 75'005tr D'.
� A.P. Number
City Zip Tel.
PaIM ft 42260 568-2928 Legal Description
Contractor Project Description �a
.1 I:. M=tA Land
Address
_ $Std
City Zip Tela u
State Lic. City i
& Classif. 2=30 Lic. # 329 Sq. Ft. W 424 No. 1 No. Dw. 1
Arch., Engr.,
Size Stones Units
Designer New,5Add ❑ Alter ❑ Repair ❑' Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing' with Section
7000) 0f Division 3 of. the Business and Professions Code, and my license is in full force and
effect. fR. f % l .�_. "=y.. ff: ;✓�r
SIGNATURE X r, DATE - .. ..
f ," "V' OWNER -BUILDER DECLARATION Estimated Valuation
n
Ihereby 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, alter, improve, demolish, or repair any structure, prior to its issuance also -
requires the applicant for such permit to. file a signed statement that he Js licensed pursuant. to - PERMIT - AMOUNT
the provisions of the Contractor's License Law, Chapter. 9 (commencing with Section 7000) of s
.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 Plan Chk..Dep... . 250.00
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). �• Plan Chk. BBI. 74.94
q I, as owner of the property, or my employees with wages as their sole compensation, will.. 391.00 4 �{+yY�
do the "work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. J�atiGt
Professions Code: The Contractor's License Law does not apply -lo an owner of property .who .
builds or improves thereon and - who does such work himself or through his own employees, Meeh. -� «>�y
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 ElectricalSgt.'
of proving that he did not build or improve for the purpose of sale.) -
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing �
struct the project.• (Sec. 7044, Business and Professions Code: $7t The Contractor's License Law .a
50
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. 5.99
- 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.
Date owner Infrastructure 4276.00
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. O. Certified copy is hereby furnished.
TOTAL I 2J79.42 1.,929.-42
CERTIFICATE OF EXEMPTION FROM REMARKS
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 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.
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.Llne
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
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR'
expiration it work thereunder is suspended for 180 days.
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.t Validated by:
Signalure'ofapplicant. � if o/ f </.�•'_�'r �/`f.7-d Date -
Mailing Addrestj Validation:
City, State, Zip `y
Jr A4580 3 b 1929,42 it
HARD COPY
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE 4,
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
FOR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT. @
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT 5Ael /`
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
WASH ER(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
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.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 3�/
///GROUND PLUMBING i//&
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 4,
f2gqUGH PLUMB. !�
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
POWER OR S I A '.
GH WIRING s /
DUCT WORK
ROCK STORAGE
FOUND. REINF. 3i l
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF.STEEL `S zJ 8G
GAS (FINAL)
TEMP. POLE
GROUT 5Ael /`
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM 5/2 7/G��
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
FRAMING S /��
FINAL INSP.
ROOFING 6
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
/GNSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL