08446 (SATT)4 PHAsE 37A: BwG - 6
P.O. BOX 1504 No. 08446
Building 78-105 CALLE ESTADO
Address ;11—Q;2 R3 V I VDA LA QUINTA, CALIFORNIA 92253
Mailing
Address 42-60£ Cn S �STF _ 20
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City lZip ITel.
Address
ty - _ IZip ITel.
State Lie.I City
& Classif. Lie. #
Arch., Engr., I
Designer
Address I Tel.
City I Zip( State I
Lie. #
f LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Divisiom3 of the Business and Professions Code, and my license isin full forceand
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Y A
S Gt•1'AT RE d•�'-' - ,I:/' .y{ r' l-�^ ^ - I'd DATE
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OWNER - BUILDER DECLARATION
I hereby affirm that I am exempt from the Conjrtors License Law for the following
reason: (Sec. 7031.5,BUsiness and Professions Code: Any city or county which requires a
permit to construct, alter, 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 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).'
O 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
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. 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.)
❑ 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
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contraclor(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 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: If, 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 a building permit when properly filled out, signed and validated, and is subject to
expiration it 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
LDING: TYPE CONST. OCC. GRP...
P. Number PGA WEST TRACT #91846-5
Description
Project Description Amass- 37A — v, Am Nit
Sq. Ft. No. No. Dw
Size 1997 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
stimated Valuation
113,727.00
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.563-06
Const. 688.50
Mech. 0
Electrical 2
Plumbing ULM
S.M.I.
7,098
Grading
Driveway Enc.
Infrastructure 2,558,86 U22HU 1,279.43
CREDITJUS
1 110 C U-32
TOTAL 2,856.41
REMARKS
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
2ND FL. SQ, FT, ®
!PAINS
KLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
K
GAR. SQ. FT. ®
POWER OUTLET
CAR P. SQ, FT, ®
DRAINAGE PIPING
WALL SQ. FT. ®
DRINKING FOUNTAIN.
SO' FT. ®
ESTIMATED CONSTRUCTION VALUATION $
NOTE: Not to be used .as property tax valuation
URINAL
WATER PIPING
FLOOR DRAIN
MECHANICAL FEES
VENT SYSTEM FAN EVAP.COOL HOOD
APPLIANCE DRYER
SIGN
WATER SOFTENER
WASH ER(AUTO)(DISH)
FURNACE UNIT WALL FLOOR SUSPENDED
GARBAGE DISPOSAL
AIR HANDLING UNIT CFM
ABSORPTION SYSTEM B.T.U.
COMPRESSOR HP
TEMP USE PERMIT SVC
POLE, TEM/PERM
LAUNDRYTRAY
KITCHEN SINK
WATER CLOSET'
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.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
PERMIT FEE
DBL TCTAL FEES MICRO FEE MECH.FEE
PERMIT FEE
PL.CK.FEE CONST. FEE
ELECT. FEE
GAS PIPING
PERMIT FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING
ELECTRICAL
HEATING & AIR COND.
SOLAR
SETBACK
ROUND PLUM S•To
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWERn K
ROUGH WIRING
DUCT WORK
ROCK STORAGE
V OUND. REINF�
�(f
G AS (ROUGH)// • on)
�/'
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
y d
$ plus
x$
LUMBER GR.
�J
([FRAMING /. _�/� \
FINAL INSP.
//
Owl INS �_2i p
Owcu.
ROOFING
_/,
R AC � V ��ih-%�
J}� - `
J/� Il ` �G� G'V
REMARKS:
VENTILATION
FIRE ZONE ROOFING -
FIREPLACE
SPARK ARRESTOR
FIREWALL
//GAR.
(�4 THING 6 q �GU
MESH
n 777
YX tkNSULATION/SOUND /� / G
111 ��`
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S
SIGNATURES/INITIALS
GARDEN WALL FINAL