14247 (RPL)P.O. BOX 1504 No.' 142.47
78-105 CALLE ESTADO •4
Address .54-700 A,ve. ' Obregon LA QUINTA, CALIFORNIA 92253
Owner
-Al, a Andrea Dooley a -
Mailing BUILDING: TYPE CONST.'''>`-•' -`- OCC: GRP.
SSE'- '
Address A.P. Number s
City Zip ]Tel.
La Qulnta, CA 92253 .7.71--0559 Legal Description
Contractorf3Sr
American po6l Cbnii tructton Project Description
Side. ..and f�roht vra;rd . 3 �. setback approv,ed
A es50'Magnesiti Pally 01 r
per setbackl' aai'ustment 94--267
City' Zip Tel.:
palm Deae:rt., � 92260 340-5876,
State Lic. ; ,.'C53 518742 City 1
& Classif. Lic. #
104
Arch -'En — -
9r•.
Designer
'ZONE:- -
! OWNER -BUILDER DECLARATION
I heieby-aff•irm that I am exempt from.the.Cont1hor's License Law for the following
subject to the Workersrs'- Compensation provisions of the Labor Code, you must forthwith
comply with such provis/ons'or this permit shall be deemed revoked.
Address
.'reason: (Sec. 7031.5, Business and Pro/essions'- 'Cod'Any city or - county which requires a
permit to consbuct alter,:.improva demolish $i-repair°`any structure, .prior to its issuance also
,i
City'
iequfres'the applicant for such permit fo ble aslgnedalatement that he is licensed pursuant to
ip
Zipf �f
_-•ahe"provisions of the Contractor's Lic en se :Law;:'Cliapter 9. (commencing with Section 7000) of -
'
;•Division 3 o/ the Business and Professions" Code; , that. he is exempt therefrom, and the basis
'for the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit
Iam]
Sq. Ft. No.
Size ' Stories
New ❑ Add'❑'t_” Alter
i
...-v. r�r---o— -r r %-� c if
SIGNATURE i J I 1 DATE
'ZONE:- -
! OWNER -BUILDER DECLARATION
I heieby-aff•irm that I am exempt from.the.Cont1hor's License Law for the following
subject to the Workersrs'- Compensation provisions of the Labor Code, you must forthwith
comply with such provis/ons'or this permit shall be deemed revoked.
Estimated Valuatior
.'reason: (Sec. 7031.5, Business and Pro/essions'- 'Cod'Any city or - county which requires a
permit to consbuct alter,:.improva demolish $i-repair°`any structure, .prior to its issuance also
,i
Front Setback from Center Line
iequfres'the applicant for such permit fo ble aslgnedalatement that he is licensed pursuant to
-PERMIT
_-•ahe"provisions of the Contractor's Lic en se :Law;:'Cliapter 9. (commencing with Section 7000) of -
coNsrRucrioN LENDING AGENCY
;•Division 3 o/ the Business and Professions" Code; , that. he is exempt therefrom, and the basis
'for the alleged exemption. Any violation o/ Section 7031.5 by 'any applicant for a permit
Plan Chk. Dep.
- subjects the applicant to a civil penalty o/ not more than five hundred dollars ($
-
O I, as owner of the property, or my employees with wages as their sole compensation, will
Plan Chk. Bal.
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 property who
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. I/, however, the building
Mech . '
or improvement is sold within one year o/ completion, the owner -builder will have the burden
Electrical
of proving that he, did not build or improve for the purpose o/ sale.)
expiration if work thereunder is suspended for 180 days.
❑ 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
Issued by:
does not apply to an owner of property who builds or improves thereon, and who contracts /or
S. M. I.
such projects with a contractors) licensed pursuant to the Contractor's License Law.)-
construction, and hereby authorize representatives of this city to enter the above-.
Grading
❑ I am exempt under Sec. B. & P.C. for this reason
mentioned property for inspection purposes._ - _
Validated by:
Driveway Enc.
Date Owner
WORKERS' COMPEN!
I hereby affirm thatxl have a certificate
Worker's COmp'errThA tfjfrl..l rance, or a certifi
OlCopy is filed with the city: -70 Certified�bopy is
{' CERTIFICATEOF:EXEMPTI
t WORKERS' COMPENSATION
(This section need not -be completed it the permit isylc
or less.) is Al, �I
I certify that!'i. the.perfofmance.of thgrworkforW
employ any perso1a iq'any manne`,•so as.to'become s�
Laws cf.Califprnia.1l ;-a. 1�i tff f
Infrastructure
fere; or a certificate of
800 Labor Code)
No. Dw.
Units
Repair ❑
Demolition_❑
AMOUNT
70.20
1
24.00'.
4.00
27.00-
-
�; yr
i.
1.00.00-
ed. ...� _ j 374.20
. _... . _ .TOTAL F N�
_ REMARKS ,-i\ r). F �-� --
dollars ($100) valuation 1714 1��1 l r• �' y 5 O 2 /
it is iss eued, I shall not FS\l • Y .
lorkers' Compensation
NOTICE TO APPLICANT: If, after making this- Certificate 'of Exemption you •should , become
'ZONE:- -
y .
subject to the Workersrs'- Compensation provisions of the Labor Code, you must forthwith
comply with such provis/ons'or this permit shall be deemed revoked.
- -. T�
Minimum Setback DlStanCeS:
.-
-
,i
Front Setback from Center Line
i
Rear Setback from Rear Prop. Line
AMOUNT
70.20
1
24.00'.
4.00
27.00-
-
�; yr
i.
1.00.00-
ed. ...� _ j 374.20
. _... . _ .TOTAL F N�
_ REMARKS ,-i\ r). F �-� --
dollars ($100) valuation 1714 1��1 l r• �' y 5 O 2 /
it is iss eued, I shall not FS\l • Y .
lorkers' Compensation
NOTICE TO APPLICANT: If, after making this- Certificate 'of Exemption you •should , become
'ZONE:- -
-- ' BY:'
subject to the Workersrs'- Compensation provisions of the Labor Code, you must forthwith
comply with such provis/ons'or this permit shall be deemed revoked.
- -. T�
Minimum Setback DlStanCeS:
.-
-
Front Setback from Center Line
ti
Rear Setback from Rear Prop. Line
coNsrRucrioN LENDING AGENCY
Side Street Setback from Center Line
Ihereby 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 ' \'-3`4
Lender's Address '•
r
FINAL DATE
- l
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.
I certify that I have read this application and state 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._ - _
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip _ I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
SEWER OR SEPTIC TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
ROCK STORAGE
FOUND. REINF.
DRAINAGE PIPING
CAR P. SO. FT. ®
METER LOOP
WALL SO. FT.
HEATING (FINAL)
DRINKING FOUNTAIN
SO FT ®
GAS (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
BOND BEAM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GRADING
cu. yd.
—Plus—X$—=$
IKITCHEN 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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. LD
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS P16
SEWER OR SEPTIC TANK
ROUGH WIRINGbp
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL Y
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
'//��/,
'
j
Fltl�
, ,f A/ T/y�'�/`y^
�WOQI_J�(31—iq t.,
REMARKS:
VENTILATION
FIRE ZONE ROOFINGa
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
t
ccn�rc c...I
3;
+
77-
9
4.......................
t
PROPERTY LINE Q UTILITY. POLEJn JJNCTION BOX HOSE 8113 04 SKIMMER DECK-aDRAIN
UTILITY EASEMENT OE ELEC.'P'ANEL QB BLOWER FILL LINE LIGHT AREA DRAIN
FENCE (HEIGHTTYPE) @ GAS
METER O VOTER -LEVELER OF FILTER DR. RETURN ==='PVC DRAIN
—E—E— UNDERGROUND ELEC. BENCH
MARK REMOTE ALVE HEATER THERAPY GRAB RAILS
—G—G— UNDERGROUND GAS sums=
OVERHEAD ELEC. •wArER. DEPTH GATE VALVE MAIN DRAIN ---4 AERATOR
:I LADDER
OVERHEAD TELE. SWITCH P TRAP' d> PUMPELEC. PEDESTAL GAS GRILL
13
ACCESS -0 RECEPTACLE ---3 STUB -t� CUP ANCHOR jf�L SEE NOTES
81SMOP GAAPHICSIACCUPRESS
REORDER NO. A275W
T�.L
La.
NOTES:
CITY Olr- L QUINTA.
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BUILDING
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PLIU-,t,,-bLE CODES
AND PLL
DATE
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91-0029"MA 02
MAP NO
LIC. # 51874
OFF)CE—a)NTRACT
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NAME AL I AWDKcA -Doc)
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SCALE : -10-0. 1-07 — BLOCK SEC
H. TELE. IL -6551 -W TELE.
A AACAN
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C CC.Nslmuc F1
74 - 350 Magnesia Falls #1
Palm Deseq CA 92260
-(619) 340 - 5876