002124 (SATT)�ha5e,()
Building 801-471. O&k TMS
Address
Owner
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 01'�.9--T
S= m sari oain'C8 Om k W
Mailing BUILDING TYPE CONST. OCC: GRP.
Address 751-M CbUntrV Cltb 'eve A.P. Number
City Zip Tel.
Pm �. .. '' 92260 568-2828 Legal Description
Contractor. Project Description PMW—M PUM 30
Address,.
BMW
City ]Zip Tela
a mm Sam
State Lic. City IM 1627
& Classif. Lic. #2$ Sq. Ft. No. No. Dw.
— M.8130Size GAR 424- Stories 1 Units
Arch.; Engr.'
Designer New EJ 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
70 OO) of Division 3 of the Business and Professions Code; and my license is in full force and
effect.
SIGNATURE - F .� - DATE
OWNER -BUILDER DECLARATION
I hereb affirm that I am exem t from the Contractor's License Law for the followin Estimated Valuation
reason: (Sec. 703 1.5, Business and Prdfessions Code: Any, city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its.issuance also
BY:
Minimum Setback Distances:
requires the applicant for such permitito file a signed statement thathe is licensed' pursuant to
:PERMIT
the provisions of the Contractor's License Law, Chapter 9-(commehcing with Section .7000) of
Rear Setback from Rear Prop. Line
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 five hundred dollars ($500): - '
Plan Chk. Bal.
O. I, as owner of the property, or my employees with wages as their sole compensation, will
'
Date3-1¢"86• Permit
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const..
Code: The Contractor's License Law does not apply to an owner,of_properly who
Validation:
builds or improves thereon and who does such work himself or through his own employees,
MecK.
provided that' such improvements are not intended or offered for sale. If, however, the building
3 10 255&76 Sl
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.). '
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
struct 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. .
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
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 lhereof.'(Sec. 3800, Labor Code.)
Policy No: Company
O Copy is filed with lhe.city. O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (3100) 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 or Exemption you should become
subject to - the Workers' Compensation provisions of the ' Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.):
Lender's Name
Lender's Address
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 stale that the above Information is correct.
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.
Signature of applicant } :- �r FLrE Date
Mailing Address
City, State, Zip /
Infrastructure
665.50
AMOUNT
364.1
443. bU
34.W
67.41
$7.50
f • is
MW
1,554.98
TOTAL I 1 Ls .i6
REMARKS �c} pyx}��
POM KIM SM isAt�l' � J.xLi,S PEMN
ZONE:
BY:
Minimum Setback Distances:
Front Setback from. Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date3-1¢"86• Permit
Validated by:
Validation:
A4655
3 10 255&76 Sl
HARD COPY
CONSTRUCTION ESTIMATE -
NO. ELECTRICAL FE
NO. PLUMBING FEES
IST FL. SO. FT. a $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION 4 $
UNITS
MOBILEHOME SVC.
POWER OUTLET I
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS 3.3!
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 bISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE FL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING E4 ECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBING' J1
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE q,
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS 3.3!
WER OR SEG �F
p
L OUGH WIRIN
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
!�
V( !� FRAMING
FINAL INSP.
/
�4ROOFING f �/_
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
yy
F'l---LATHING /C F
MESH
//
LOLINSULATION/SOUND G
r
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
g j_, L D a`f W e\"— `7/ l/,Op