002147 (SATT)Building 8 25 Oak
Address
Owner
Mailing
Address 75_00.5 C011ntW C.i
City Izip
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Contractor
Address
Sam
•- City... _ Zip Tel:
State Lic. City
& Classif.$ Lic. # ....�.
Arch ,-Engr.; '
'..Designer
Address
Tel.
No... 002147
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number.
Legal Description
Project Description �` m
I.Uir1Ci 1338
Sq. Ft.MR X24 No: No. Dw. g L
Size Stories Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
City
Zip
State
.Lic..# ..
LICENSED CONTRACTOR'S DECLARATION
•• IIhhereby: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... \.. ^ s`
.. .. . . - . '. .. .
SIGNATURE? fZ...•• , l - Y DATE'
+' OWNER•BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law .for the following.
Estimated Valuation aa
,• reason: (Sec. 7031.5,Business-and Professions Code: Any city Or 'county which requires a,
- ••
- PERMIT' • AMOUNT -
- 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
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
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:'
❑ I,,as owner of the property, or my employees with wages as their sole compensation, will -
.
- - -
PIan-Chk.�Deji...
Plan Chk. Bal. 324.94
Const. � .
• '
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and,
Professions Code: The Contractor's License Law does not .apply to. an owner of- property, who
Mech. .1-f1d
builds or improves thereon and who does such. work himself or through his own employees,
provided that such improvements. are:not intended or offered for sale. If, however, the building
_
Electrical ra'�t '
or Improvement is sold within one year of completion, the owner -builder will have. the burden
. of proving that he did not build or improve for the purpose of sale.)
Plumbing. 87.50struct
' O 1, as owner of.the property, am exclusively contracting with licensed contractors to con-
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.W. - 5_99 ^
such projects with a contractor(s) licensed pursuant to the. Contractor's License Law.)
❑ 1 am exempt. under. Sec.. B. & P.C. for this'reason '
-
Grading
Driveway Enc.
Date owner
Infrastructure 1,276.: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
❑ Copy is filed with the city. . ❑ Certified copy is hereby.furnished.
TOTAL 2.179.42
REMARKS
CERTIFICATE OF EXEMPTION FROM
• 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.
j L AW SPA Wr Pte.' OF MM MOW.
Date' Owner'
NOTICE TO APPLICANT: If, ager making this Certificate of Exemption you should become
' subject to the' Workeis' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: _ BY: • '
Minimum Setback Distances: -
Front :Setback.fTom Center. Line
Rear Setback from Rear Prop. Line
CONSTRUCTION. LENDING AGENCY
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 Street Setback from Center Line
'Side Setback from Property Line
Lender's Name
FINAL.DATE I PECTO
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 state that the above information is correct.
'Iagree to comply 'With all city and county ordinarices and state laws relatingto building'
Construction, and hereby authorize representatives oof this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant,' °� Date
JssUed by: Date Permit
Validated by:
Mailing Address 1 �•- ' - _ -
Validation:
A4b38 3 16`1 2.119,42 Sl
„
City, State, Zip
w HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EFAfmk
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
2ND FL. SQ. FT.
COLL. AREA
YARD SPKLR SYSTEM
POR. SQ. FT. p
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
FORMS
DRAINAGE PIPING
WALL SQ. FT.
,r-LQNER OR S I
DRINKING FOUNTAIN
SQ. FT. ®
DUCT WORK
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
METER LOOP
FLOOR DRAIN
MECHANICAL FEES
OTHER APP.IEQUIP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GROUT
LAUNDRY TRAY
AIR HANDLING UNIT CFM
WATER HEATER
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
FINAL INSP.
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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
PLUMBING / /!
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE/C
/y
P14UGH PLUMB. 6
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
,r-LQNER OR S I
/
q,40UGH WIRING (J L
/
6
DUCT WORK
ROCK STORAGE
FOUND. REINF. %
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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.
FRAMING � x
FINAL INSP.
ROOFING Gi S
VENTILATION
6
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
r
1'
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
• FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS•
GARDEN WALL FINAL