002114 (SATT)Building
Address "4.35 Oak i
Mailing
Address 7S Climml
City Zip
.. PainD�
Contractor
Address.SIM
.
44
P.O. BOX 1504 No. 002114
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
ttlr A.P. Number
Tel.
5f0-2828. Legal Description
Project Description VIM IrAM R.' =AtC A
Tel..
State Lic.
City
LiG9G..t:iM
& Classif. 288130
Lic. # 328
Sq. Ft. GR 424
No. No, Dw.
Size
Stories -- Units
Arch., Engr.,
Designer
New LSI: Add ❑
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) of Division 3 o the Business and Professions Code, and my license is in full force and
effect.
(J _ .
..
SIGNATURE,; V etF {i r= P--' - d �•'�:�-" iJ' }' :DATE
..
.
"�� " ` 'OWNEWBUILDER DECLARATIONEstimated
I hereby, affirm that I am exempt from the Contractor's License Law for the following
Valuation
j
R '��'J• 50
reason: (sec L. M31..5,Business and, Professions Code: Any city or county which requires a
/ '
permit to construct, akar, improve, demolish, or repair any structure, prior to . its issuance also
.x
requires the applicant for such permit, to rite a signed statement that he is licensed,pursuant•to
PERMIT
- AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
'
Division 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..
� • �
'subjects the applicant to a"civil penalty of not more than rive hundred dollars ($500).'
Plan Chk. Bal.
145.60
❑ 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
Corfst.
- K�
Professions Code: The Contractor's License Law does not apply to an owner of property ,who
• JN
builds or improves thereon and who does such work himself or through 'his own employees,
Mach.'
'
provided. that such improvements are not intended or. offered for sale. If,. however, the building"
•�A+
or improvement is sold within one year of completion, the owner -builder. will have the burden
Electrical
74.69
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-
Plumbing -
87.50struct
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
S.M.I.
8.30such
projects- with a contractors) licensed pursuant to the Contractor's -License Law.)
Grading
_ El I am exempt under.Sec. B.•& P.C. for this reason.
Driveway Enc.
Date owner
Infrastructure
'11805.97
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
2.891.56 2.6A-I.53�
_
CERTIFICATE OF EXEMPTION FROM
.REMARKS
_
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
s aim yen hers
Air �A PART �y,�, IDUS PRIMer,
'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: n, alter making this Certificate of Exemption you should become ZO.N E: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith -
complywithsuchprovisionsorthispermitshallbe deemed revoked. 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
- 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: -#@ permit
I certify that 1 have read this application and state that the above information'is correct. _ ISSued'by: Date
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. • x st/ Validated by:
Signature of applicant)/ice•'
Mailing Address r� `�`:" Validation:
City, State, Zip r + / _ ✓
A4.5i2 3 6 2641..56 ft
HARD COPY
CONSTRUCTION ESTIMATE
Adillill NO. ELECTRICAL FEES AMR,
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE 2 8G >< N
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APP.IEOUIP.
DRINKING FOUNTAIN
SQ. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT S/Z 53 e5 1Z k
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.000L 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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR Q lAc
HOUSE SEWER
/f—IdATHING
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 / ! .fir
GROUND PLUMBING 3�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 2 8G >< N
)e?OUGH PLUMB. al
O�
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
2ll� SEWER OR SEPTIC T K
2�f�UGH WIRING f X445
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL 311,1OWf, !y
GAS (FINAL)
TEMP. POLE
GROUT S/Z 53 e5 1Z k
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM !;f�6 2�
.271
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—X$—=$
LUMBER GR.
FINAL INSP.
FRAMING S�sf 06��
FINAL INSP.
ROOFING s' h
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/f—IdATHING
MESH
9'
kINSULATION/SOUND S f
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIG NATURESIENITIALS
GARDEN WALL FINAL
vz% w4 -1l XIlTC6t5 X,4!�