08441 (SATT)Building
Address
Owner
Mailing
Address
City
r
Address
City lZip Tel.:
State L Lic. City
& Classif. 288130 Lic. #
Arch.,Engr:,
Designer
•
fliAtt 1-37A v BLDG 5/2MR,
P.O. BOX 1504 NO.
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. -7 OCC'. GRP. -
00 A.P.. Number PGA WEST TRACT
Legal Description
Project Description,"pugisc 37A Of Atli 2"D
Sq. Ft.
Size
New El
�No.
Stories
Add.0 ., Alter 0
No. Dw.
Units
Repair.0 -Demolition 0.
Address
Tel.
City.
State
Tip
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby that"I arri'licensed under provisions*of Chapter 9 (commencing with Section
70000f Division,�f thb Business and Professions Code, and my ficens full force and
%
SIG qV�-- Y W7 K:ux��F—
IPTURE DAIE
OWNEh-BUILDER DECLARATION
/ '
Estimated Valuation
I hereby affirm hat .1 am exempt from
ha m.the ContR,5&r's License Law for the following
108 585 00'
reason; (Sec. 7031.5-StIsiness and Professions Code. Any city or county which requires a
'to
.. ,
permit 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
PERMIT AMOUNT
• ,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 - Section 7031.5 *any
Plan Chk. Dep.
violation of by applicant for a permit
sublebts the applicant to a civil penalty 9fnot more than five hundred dollars (8500).
P Ian Chk. Bal.
0 1, as owner of the property, or my employees with wages as their sole compensation, will
cl-fin Olt
do the work, and the structure is.not intended or offered for sale. (Sec. 7044, Buisness and
Const. BMW
Professions Code: The Contractor's License Law does not. apply to an owner of property who
'work
builds,or imoroves-there6h and who does such himself or through his own employees,
Mech.
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
Electrical
of proving that he did not build or improve for the purpose of sale.) %
• 0 1, asowner 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
does not apply to an owner of property who builds or improves thereon, and who contracts for •
S. M. 1.
L 63
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
-Grading
0 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner
'Infrastructure 2-hu2,2S 10221.14
LEGS GIREWT
WORKERS' COMPENSATION DECLARATION
IV""` V-- --------- ---
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
0 Copy is ifledwith the city. 0 Certified copy is hereby furnished.
.'TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKE RS'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 thp work for which this permit is issued, I shall not'
=any person in any manner so as to become subject to the Workers' Compensation
California:ai
f ft-ArT' 6 1 2 4
Date �Owner
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become
ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permitshallbe deemed revoked.
Minimum Setback Distances,
—Front Setback fromCenter Line
_Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
Iaffirm that that is a construction lending agency for the performance of the
work forch 'his permit is issued. (Sec. 3097, Civil Code.)
Side Setback fr6im Property,Line
Lender's Name
Lender's. Address
FINAL. DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 186 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.
Naliclated by:
Signature of applicant. —Date
Mailing Address
z.Validation:
City, State, Zip
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 SO. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM F^N EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUG�O2_ , i/
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 ® 1+/a c
SEWAGE DISPOSAL
0/2- 7-v
1 O' v PSV
SQ.FT.GAR ® 3/ac
HOUSE SEWER
VENTILATION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
DOTAL 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
TU�SEWER 2A v6g(; v
ROUGH WIRING,
DUCT WORK
ROCK STORAGE
FOUND. REINF.&
r U
GAS (ROUG�O2_ , i/
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
INAL INSP. /�
/
RAMING / `G—�//
FINAL INSP.
OFINGU — — O
0/2- 7-v
1 O' v PSV
REMARKS:
VENTILATION
FIRE ZONE ROOFINC
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/
THING// p
MESH
0�IySULATION/SOUND//-/� /`4?U
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL