002151 (SATT)P.O. BOX 1504 No. 002151
Building 78-105 CALLE ESTADO
Address 80- 49 Oak Tree LA QUINTA, CALIFORNIA 92253
Owner
W%r4_*0 Tss f'iN� i.w rBUILDING: TYPE CONST. OCC- 'GRP.
Mailing
Address WHO Qoyry a xib Prim—, A.P. Number
CityZip Tel.
92261 8—= Legal. Description
Contractor 1 ' - Project Description TGA WRMT.,XAM 0 R
f{ATr+tFl lvre'n"'a-�►e�n x�r? X'a�rt,t"�
,Address . - .. .
City .. Zip Tel.. ..
s�:clrt'a�
State Lic. City DW 1548
& Classif. Lic. # Sq. Ft. No. No. Dw.
. 17 sal -n T)A Size MR . 424.... - Z
Stories - Units
Arch., Engr.;
Designer New QI 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
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE -i J. d'r .sst . DA
- _ - - 'TE .. .. ._ ..
�OWNER•BUILDER DECLARATION
i Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason
:r _
(Sec. 7031.S,Business and Professions Code: Any city or county- which requires a ,
permit to construct, alter, improve, demolish, or repair any structure, prior to d1s: issuance also. - -
requires the applicant for such {permit to file a signed statement that 'he is -licensed pursuant toPERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section. 7000) of x.� '
Division 3 of the Business and Professions Code, or that. he'is.exempt therefrom, and the basis plan• Chk.: De '
for the alleged exemption. Any violation of Section 7031.5- by 'any applicant for a permit p '
subjects the applicanfto a civil penalty of not more than five hundred'dollars ($500). Plan Chk..B' ` ,3
0 I, as owner of the property, or my employees, 70
with wages as their sole compensation, will s
do the work, and the structure is not intended or offered for sale. (Sec. 44, Buisness'and COr1St.
Professions Code: The Contractor's License Law does not ,apply. to an owner of property who . - `I t�lf{
builds or improves thereon and who does Such' work himself or'through his own' employees, "- • - .. •r , - _
provided that' such improvements are not intended or offered. for sale. If, however,'the building Mech.' iA ft
-or improvement is sold. within one year of completion, the owner -builder will have the burden EleCtrlCdl - �- v �C
of proving that he did not build, or improve for the purpose or sale.) Ca
AA
❑ 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. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
CI I am exempt under Sec. B. & P.C. for this reason Grading
Driveway Enc.
Dateowner - 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 2.437.117
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE -
(Thiss:ection need not be completed'if the permit is for- one hundred dollars ($100) valuation y A,1 *, gp�1C S'(gF� t .• p M22"=,
or • -
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 ZONE: - BY:
'subject 'to the Workers' Compensation provisions of. the 'Labor Code, you must' forthwith' MInImUmSetback Distances:'
comply with such provisions or this permit shall be deemed revoked.
Front. Setback from Center Line
Rear Setback from.Rear Prop'Eine
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, Civilcode.) 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. 3'rl�t"'3�
I certify that I have read this application and state that the above information is correct. 'Issued by:.' Date l�t"j Permit
I agree to comply with all city and county ordinances and state laws relating to building r
construction, and hereby authorize representatives -of this city to 'enter the above
mentioned property for inspection purposes. Validated by:
Signature of applicant k.7 t f +` %� ' +.• Date
Mailing Address /f r " f,"r�- - �w `' - - Validation: -
City' State, Zip ! L*' y
/ A4b453 l0 2437.17 Sl
.� HARD COPY _ ..
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EFaak
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
gUGH PLUMB. 7/3
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT. ®'
GAS (ROUGH)
DRINKING FOUNTAIN
SQ FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -Plus-X$-=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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
FIRE ZONE ROOFING
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/4c
HOUSE SEWER
GAR. FIREWALL
GAS PIPING
PERMIT FEE
LATHING
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
ME--H.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
gUGH PLUMB. 7/3
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SFW19R SEPi5R
R (iN'WIRING 7
DUCT WORK
ROCK STORAGE
FOUND. REINF. G
,!
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.
FRAMING % A!PP�/
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
($ULATION/SOUND y®
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/IAITIALS.
GARDEN WALL FINAL
19P w,-"( 7rt1w1e4--1