002107 (SATT)44
P.O. BOX 1504 No. .002107
Building 78-105 CALLE ESTADO
Address _AA7' fVAr nsrvk+ LA QUINTA, CALIFORNIA 92253
Owner
` BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 75--005 f3E -A ..Zy ClAft D^.. A.P. Number
City Zip Tel.
0 g%_2pMLegal Description
Contractor Project Description PQ W—M P + M
Address_ -.. — ----- _.
Sim
City Zip Tel.'.
c'x1ti�f•3
State Lic. City DVr 1330
& Classif. 1"I 14A Lic. # 129 Sq. Ft. No. No. Dw.
" Size Stories -• Units '
Arch:; Engr.,
Designer New ❑g Add ❑ Alter ❑. Repair ❑ Demolition .0 .
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 a
7000) of Division !of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE, '1 .0'. �•.f�...v' `�" - s .•DATE .. .. .. .. ..
1 ,r' O,WNERaBUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason:' (Sacs 7031.5,Susiness and Professions Code: Any city or county' which requires a
permit -to construct, alter, Improve, demolish, or repair any structure; prion to its issuance also r
' requires the applicant.for.such permit to file 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.- I1..�T0
subjects the applicant to a civil penalty'of not more than five hundred dollars ($500): '
Plan
O I, as owner of the property,. or my employees with wages as their sole compensation, will .CFik. Bal. 74.94
do the work, and the structure is not intended or offered for sale. (Sec. '7044, Buisness and Const. r�
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, Mech..
.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 Electrical J SqAQ
{�
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 A7.50
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Lew -
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I.�i}i
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)'
Grading
❑ 1 am exempt -under Sec. B. & P.C. for this reason
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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL _'E'i�_!T9 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 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 ofthe
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. '
I certify that I have read this application and -state that the above information is correct. Issued by: Date 1--y-S-AR 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 applicant f ^! , l r Date•')I� r >
Mailing.Address 1 S 11.i i Validation:
City, State, Zip y r r
A 4 5 8 0 3 6 X929,_42 it
.� HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES s `
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT. p
2//UGH PLUMB.�y 6
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
SEWER OR EP 1MNK/—///
/?,ROUGH WIRINGfZ,,/
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT. ®
HEATING (FINAL)
OTHER APP./EQUIP.
WALL SQ. FT.
GAS (FINAL)
DRINKING FOUNTAIN
SQ. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
I WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
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 S Z
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MErH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK 3 /� ' f/
r C4ROUND PLUMBING �/
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �? �6�j %/
2//UGH PLUMB.�y 6
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR EP 1MNK/—///
/?,ROUGH WIRINGfZ,,/
Qi
7 vis
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL 7 // O� f�
GAS (FINAL)
TEMP. POLE
GROUT S/� �6 h�
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM S 271
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING S / 6
FINAL INSP.
ROOFING �/, /
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING S Z
MESH
4NSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESANITIALS,
GARDEN WALL FINAL