002152 (SATT)P.O. BOX 1504 -NO.- 402152
Building 78-105 CALLE ESTADO
Address 55 C'. Tree LA QUINTA, CALIFORNIA 92253
Owner ...
- La Quiyta CXv;xmV BUILDING: TYPE CONST: OCC: GRP. -
Mailing
Address. 7s-.mcbU,cub
Driva q, p. Number
City -Zip Tel.
Phi 922609226x0 562'-282 Legal Description
Contractor Project Description FM WIRM VTAN 3 C R
#°i-rrro+rQo a�xs
T=Vul
Address. e _
City Zip Tel...
State Lic. City 1627 '
& Classif. Lic. # • Sq. Ft. No. No. Dw.
Size 0 Stories 2" Units
:Arch., Engr.;
Designer New Add ❑ Alter ❑. .. Repair ❑ Demolition ❑
Address Tel.
CityJZip State
_ Lic. # ..
LICENSED CONTRACTOR'S DECLARATION_ _
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing'with Sectiori - -
7000) of Division 3 of the Business and Professions Code, and my license. is in full force and
effect.!
SIGNATURESs s;' ��� `• F.'-- ! 3-s%�'- -a_... A � � - t.� DATE
OWNER -BUILDER DECLARATION— .
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated VBIUatIOn `nt6•
reason:•(Sec. 7031.5,Business and Professions Code: Any,city or. county which requires a '
10 V
permit io construct, alter, improve, demolish, or repair any structure, prior to its issuance also
-requires the applicant for such-permi0o file a signed statement that he•is licensed pursuant to ' - PERMIT AMOUNT
the provisions of the Contractor's.Ucense Law, Chapter 9 (commencing with Section 7000) o/ : ^t
Division 3'6f the Business and`Professions Code, or that. he is 'exempt therefrom,' and the basis --
for the alleged exemption. An violation o/ Section 7031.5 b y 'an Plan Chk. Dep..'- - -
g p y � y 'any. for a• permit
subjects the applicant to•a civil penalty o/ -not more'than five hundred dollars ($500). .L
,. set 1
O I, as owner of the property, or my employees with wages as theirPlan Chk. Bal..- .i>DH
sole compensation, will - � •J.9 _
do the work, and the structure is not intended or'offered. for sale. (Sec.'7044,•Buisness and.COf1St.
Professions Code: The Contractor's License Law does not apply to an :owner of,property. who.,9.TCI .,
•builds or improves' thereon -and who does such workhimself or through. his own employees, Mech.
- provided that' such improvements are not intended or offered /or sale. If, however, the building
or improvement is sold within one year of completion,- the owner -builder will have the burden Electrical - 67 41'
o/ 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'
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 /or - S. M. 1. - - -'T i!'
such projects with a contractors) licensed pursuant to the Contractor's License Law.) - -
Grading
O I. 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_5.71�
CERTIFICATE OF EXEMPTION FROM REMARKS
'WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit is. for one hundred dollars ($100) valuation
.. or less.) _ .. ......
I certify that in the performance of lhp work for which this permit is issued, I shall not T7�?11J! +�jjC1.
employ -any person in any manner so as•to become subject to the Workers' Compensatiorc. � ••---- Cj --- - -- -
Laws of California.
Date Owner '
NOTICE TO APPLICANT: If, alter 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
M 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.) Side Setback from Property, Line
Lender's Name
Lender's Address
. This is a building permit'when'properly filled out, signed and validated; and'is subject'to . FINAL DATE INSPECTOR
expiration it work thereunder is suspended for 180 days.
I certify .that .l have read this application and'stale that the above information is correct. Issued by:'' Date 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. J , I. Validated by:
Signature of applicant] 4•I 7%:.»a:- F f r� . - Date `'! ! i-'
Mailing Address /➢ " f = �" `~` Validation:
City, State, Zip • +�' J
A 4 6 5 9 3 10 2..55&1/'6-411
HARD COPY _ .
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FE
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE .L
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. I SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APP./EOUIP.
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
I WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING �/k
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REMARKS:
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING � S C 1-11 - -
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
&ULATION/SOUND 7 g
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
17 6PUND PLUMBING A-
�%- UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE .L
GH PLUMB. 7131,476
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
f`9Ef R OR SEgf A
7-etUGH WIRINGa
DUCT WORK
ROCK STORAGE
FOUND. REINF. L
i
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
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 �/k
FINAL INSP.
ROOFING �j �j�9:2�
VENTILATION }T
-
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING � S C 1-11 - -
MESH
&ULATION/SOUND 7 g
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/IN TIALS
GARDEN WALL FINAL