10296 (PLBG)P.O. BOX 1504 No. 10296:
Building ���Q ��� • �� 0 7&105 CALLE ESTADO
Address g LA QUINTA; CALIFORNIA 92253
Owner / T
AAs /bad. nil. m4ar o Lalli.
BUILDING: TYPE'CONST'-� OCC: GRP.
Mailing "-�
Address same
A.P. Number 774-242' 008
City Zip Tel..
La Quinta • 92253 Legal Description'
Contractor Project Description'
,rooks & Associates Se�rex Hook LP
86-996 Avenue 52
ci'boachella ziPS22w6
State Lic.
& Classif. 57630
City
Lic. # 654 Sq. Ft. - No.
Size Stori
Designers -
Address Tel.
New ❑ Add ❑ Alter ❑
—"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 anrrd•Professjons Code, and my license is in full force and
- effect' ,'� 11.< I b- �_:; :� .!„ '�_r�i�, _ � %%'- l! • C%`
SIGNATURE -Ir - DATE
OWNER -BUILDER DECLARATION - Estimated.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,
' .permit to. construct, after, 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
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
- . 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 town owner of property who
builds or fmprove's thereon and who does such work.himself.or through his own employees,
-.. prodded that' such improvements are not Intended or offeredfor sale. If, however, the building.-.
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.)' ,
PERMIT -
y
Plan Chk. Dep.
• Plan Chk. Bal. .
Const.
'Mech." •' "•
Electrical -
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con--
struct the project. (Sec. 7044,- Business and Professions Code: The Contractor's License Law
S.M.I. -
^ does not apply to an owner of property, who builds or Improves' thereon, and who contracts for.
•'such projects with a contractor(s) licensed pursuant to the Contractor's License Law )
No. Dw. f
Units
Repair ❑ Demolition ❑
AMOUNT
n.
30. Uu
❑ 1 am exempt under Sec. B. & P.C. for this reason Grading
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.
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 thg work for which this permit is issued, 1 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: ff; - 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 abuilding 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:
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 Date
Mailing Address
City, State, Zip
TOTAL .3 • UU '
REMARKS r n 5 s 1 _"?ri__s?4 a 0 3Q S70
a
ZONE:—
Minimum
ONE: MinimumSetback 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 Permit
'Validated. by: '
.Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT, ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROUGH WIRING.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
DUCT WORK
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH 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.
FRAMING
FINAL INSP.
ROOFING
/(y/I/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL