06534 (SFD). IIG0
'1�1 2 Z=-
Gv
P.O. BOX 1504 No. 065343�3
Building 54-760 Riviera 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
sumtse Company
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 42-600 Cook Sia. 0200 A.P. Number FGA West — Tract 2._317-1
City Zip Tel.
Palm Desert 92260 568--2828
Contractor
Address
State Lic. City
& Classif. 288130 1 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
City (Zip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
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 DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buaness and Professions Code: Any city or county which requires a
Permit to conSbuCt, after, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that hes 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 avB penalty of not more than five hundred dollars (5500).
❑ 1, 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 to an owner of property who
buflds or improves thereon and who does such work himself or through his own employees,
Provided that such improvements are not intended or offered for safe. ff. however, the building
orimprovement Is sold within one year of completion, the owner-Duider will have the burden
of proving that he did not build orrnprove for the purpose of sale.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Bus -Dress 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
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
Date owner
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 ff the pemrit 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.
Date Owner
M077CE TO APPLICANT: ff, after making this Certificate o1 Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
conpry with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name
Lenders Address
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certity that 1 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
Legal Description
Project Description RPhase 2E, P1= G2A
Sq. Ft. 335&No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
(Estimated Valuation $243,166
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
t.49R4�R1'.TPt'�� f
TOTAL
AMOUNT
REMARKS �:ilTr> i :•1,�3 :� �.# tip f ds—s�9ti 1; tri ft
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATEN PECTOR
CJ�SJ 1011.9
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES'
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL SQ. FT.
PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
EWER OR SEPT
ROUGH WIRING.
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
D. REINF.
GAS (ROUGH)Gc�
`
DRAINAGE PIPING
CAR P. I SQ. FT.
HEATING (FINAL)
OTHER APPJEQUIP.
WALL SQ. FT.
GAS (FINAL)
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as F roperty tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
�ff
INAL INSP!'/-� 9- d
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OFING
////
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
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 GOND. SOLAR
S ACK
UND PLUMBING /�
PfOUGH
NDERGROUND
A.C. UNIT
COLL. AREA
GRADE
PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORS
EWER OR SEPT
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
D. REINF.
GAS (ROUGH)Gc�
`
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
EINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
�ff
INAL INSP!'/-� 9- d
AMING 2 _
FINAL INSP.
OFING
////
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OOle(r�0"/g�
/1
O�� O G t�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
g/ILATHING
MESH
INSULATION/SOUND -(0 -4C./
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
`
GARDEN WALL FINAL
t