06342 (SATT)Building 54•-817 Riviera
Building
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA; CALIFORNIA 92253
Owner
51mrive y
Address 75-0051 CountTY Count.Club drive
City lZip ITel.
92260 1 568-2828
Contractor
City
State Lic. City
& Classif. 2€8130 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
City (Zip ( State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hero affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7000) bf bnnsion 3 of the Business and Professions Code, and my -license is in full force and
effect
SIGNATURE - f y DATE
OWNER -BUILDER DECLARATION !
I hereby affirin that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5.8siress and Protesslans Code: Any city or county which requires a
permit to construct. alter. irpuvq demoish. or repair any structure, prior to its issuance also
requires the apiplcanl for such Perms to fie a signed statement that he is licensed pursuant to
the provisions of the Contractors 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 viobtion of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a chl peraly of riot 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 Con&acrors License Law does not appty to an owner of property who
builds or reproves thereon and who does such work himself or through his -own employees,
Provided that such irpoverrrerds are not intended or offered for sale. If, however, the building
OF irprovernent is sold wNd One year of completion, the owner -builder will have the burden
Of proving that he did not build or irprove for the purpose of sale.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, dress and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or Onproves thereon, and who contracts for
such projects with a coetraclov(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
Workers Compensation Insurance, ora 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 canpleted if the permit 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
NOTICE TO APPLICANT: f, after =07g, this Cer ilwate 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 shag be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Ciel Code.)
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity 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 herby authorize representatives -of this city to enter the above.
mentioned property for inspection purposes
Signature of applicant Date
Mailing Address
City, State, Zip
No.
0632
ILDING: TYPE CONST. OCC: GRP.
'. Number PGA West " Phase 30B
Legal Description
Project Description Tract 24317a -I, Plain 40H
Sq. Ft. 3142 4 No. _ No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
3timated Valuation
$215,834
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 859.03
Const.
1,045."
Mech.
82.50
Electrical
i53.47
Plumbing
200.00
S.M.I.
15.12
Grading
Driveway Enc.
Infrastructure
$4,856.26
2,428.13
Lean G•rpAit
2.428.13
TOTAL
$4.793.75
% � v� " 3 . %j
REMARKS
rr:a,+;c►; to CVW, ^i recti__.00 #t�
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 DATE INSPECTOR
Issued by: Date 9/20/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SQ. FT. ® $
UNITS
SLAB GRADE �J_
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL Sp. FT. @
FORMS
SEWER OR SEPTI /Y ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)3-METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CAR P. I SD. FT.
GROUT
WATER HEATER SERVICE
WALL Sp. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE Not to be used as F roperty tax valuation
1
RAMING (_ l —�! J
!�`�
FLOOR DRAIN
MECHANICAL FEES
Of ---I y- o Gt/� /�"�j!' I— �2 L J
L� ... 2— a
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
.VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WAUL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
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.
SO. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T I.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
JDBL
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLUMBING! UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �J_
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI /Y ROUGH WIRING
DUCT WORK
ROCK STORAGE
REIN F
GAS (ROUGH)3-METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
L
F. STEE
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
CU. yd.
plus x$
=$
LUMBER GR.
F AL INSP.ae
1
RAMING (_ l —�! J
!�`�
FINAL INSP.
OOFING /
Of ---I y- o Gt/� /�"�j!' I— �2 L J
L� ... 2— a
REMARKS:
.VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
RING .2 rr_
MESH
INSULATION/SOUND /✓q, ld
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL