002127 (SATT)4
P.O. BOX 1504 No. 002127
Building�0-489 , rA$0 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Sualm La Quinta Omqmy BUILDING: TYPE CONST. OCC: GRP. -
Mailing - •
Address 75-005 CMmtry Chi? DriVv A.P. Number
City Zip Tel.
Palm DeSext 568-,282 Legal Description
Contractor Project Description Win V' ' TIT -3 (M
Address
Sam
" City Zip Tela
taar?�
State Lic. City UC 1527
& Classif. 288134 Lic. # 329 Sq. Ft. No. No. Dw.
Arch., Engr.,
Size M 42A Stories Units
'
Designer New 5_ 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 of,the Business and Professions.Code, and my license is in full force and '
..effect..2,A_
SIGNATDREA DATE
'OWNER -BUILDER DECLARATION -
rEstimated Valuation
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 I
510
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 -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 five hundred'dollars ($500): Plan Chk. BBI. 36� .
O I, as owner of the property, or,my employees with wages as their sole compensation, will �y
- do the work, and the structure is not intended or offered for sale. (Sec. 7044; Buisness and Const: Professions Code: The Contractor's License Law does not "apply to an owner of propertywhoaJST
builds or improves thereon and who does such work himself or through his own employees, Mech. 34.00
or
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 Eledtrlcal 67.41
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 87.50 .5
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.) .
11I am exempt under Sec. B. & P.C. for this reason Grading
Driveway Enc.
Date owner Infrastructure 1#554.98
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
0, Copy is filed with the city. .❑ Certified copy is hereby furnished.
_ TOTAL.
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE. �T �f�e�!��1t
(This section need not be completed if the permit is for one hundred dollars ($100) valuation "M AM 2 PM I� art•�,� PMMA
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
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 statethat 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 • i c� Date
Mailing Address
City, State, Zip 'r 4
HARD COPY
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:
Date 3--10--86 Permit
Validated by:
Validation:
A4654
3 10 ?_55876 Sl
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EFJgkk
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
I SLAB GRADE 3 J/
2ND FL. S0. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN
SQ. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
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.
SQ. FT. ® c
BATH TUB
SPARK ARRESTOR
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
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
ROUND PLUM BI Y�
UNDERGROUND
A.C. UNIT
COLL. AREA
I SLAB GRADE 3 J/
OUGH PLUM
BONDING
HEATING (ROUGH)
STORAGE TANK
AtFORMS L (
SEWER OR SEPTIC TAN1
/
UGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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.
/
LIZ'— FRAMING c
J
FINAL INSP.
ROOFING f � � l+
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING 7 /
MESH
/
ZL,rINSULATIONISOUND
�v
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL -
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL