04761 (SFD)14
4
P.O. BOX 1504
Building '55-293 Riviara78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
$urtriae Company BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address . 75-005 Country Club
CityZip Tel.
atm Desert 92260 568 -'2822 -
Contractor
National Mortgage
Address
Eames
Zip I Tel.
State Lic. 288130
PGA West - phase 2PS
Plan F3
(City 398
& Classif.
Lic. #
Arch., Engr.,
No. Dw.
Stories Units
Designer
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City . (Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 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,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 (5500).
❑ 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 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 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 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, alter 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.
,A.P. Number
,Legal Description
Project Description
PGA West - phase 2PS
Plan F3
Side Street Setback from Center Line
I= affirm that there is a construction lending agency for the performance of the
Sq. Ft. 3038"No.
Size
No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
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 180 days.
Estimated Valuation
$217P204
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
construction, and hereby authorize representatives -of this city to enter the above-
Const.
y ..r�
Mech.
J :11+. VV
Electrical
i v .9 4
Plumbing
I i3 UV
S.M.I.
`l 44 CT
Grading
Driveway Enc.
Infrastructure
V4 ti d -1 0!* 4 0 4 44 0 • !3
ee 1=001t 2 p 4 4 J
TOTAL
REMARKS
t>>'�+'Y#+r's,,wtY^ t --;i ^ir'�tHr A� `••riwy�il9
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I= 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
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 180 days.
11
1 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
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO F1 y S
UNITS
COLL. AREA
2ND FL SO FT.0
YARD SPKLR SYSTEM
POR SO FT. a
MOBILEHOME SVC.
BAR SINK
GAR SO. FT. a
POWER OUTLET
ROOF DRAINS
ROUGH WIRING
DUCT WORK
DRAINAGE PIPING
CAR P. SO FT. 4V
S (R/UGH) �. Z([/Q
WALL SO. FT. Q
HEATING (FINAL)
DRINKING FOUNTAIN
SO. FT. a }
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
GRADING
cu. yd.
$ -plus-x$
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.
KITCHEN 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
FIRE ZONE ROOFING
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID r 1'A c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE MECH.FEE
i'L.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SE ER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
S (R/UGH) �. Z([/Q
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
(FINAL) 4
TEMP. POLE
GROUT
WATER HEATER
Pm Fe
VICES. -(s
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$
c $
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR'
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINS GRADING
INSPECTION ) f�
i
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL