003304 (ELEC)• UWA
P.O. BOX 1504 NO. 40; � a
Building 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
iii ISE CORAM
Mailing `
Address 75-005 COST CLUB DRM
City Zip ITel.
. . PA�d O>�„ P- 92260 . `.64-C
Contractor
.. IMI AL LAW &t Q'=
Address
75-005 CGUMY CUB DRM
City JZip ' Tel."
BUILDING: TYPE CONST. OCC: GRP.
A. P-.. Number
Legal Description
Project Description 10�AW MRSA FWk V- WM14i ;T
State Lic.
City
& Classif.
•
Lic. # -328
Sq. Ft.
Size-
No. No. Dw.
Stories Units
Arch., Engr.; _. .. -. ..
" Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
tv
I 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 andeffect. i'
-
SIGNATURE'"`•"- r i> DATE
OWNER -BUILDER DECLARATION
' I hereby affirm that I am exempt from the Contractor's 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 rile 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 applicantfor a permit
'subjects the applicant to a civil penalty otnot more than five hundred dollars ($500).
_ ❑ _l, as owner of the property, or my employees with wages -as their sole compensation, will
Estimated Valuation
-
PERMIT
•- AMOUNT
'
_
Plan Chk. Dep. ••
_ "
Plan Chk.. Bal.
.
COr1St. .
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
Mech.
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
Electrical
.
w 50
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.)
Plumbing
❑ 1, 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
. S.M.I.
such projects with a contractor(s) licensed pursuant to the- Contractor's License Law:)
❑ I am exempt under Sec..B. B. & P.C. for this reason
Grading
Driveway Enc.
Date Owner
Infrastructure
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.
TOTAL.5z
REMARKS
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.) - -
certify that in the performance of thg work for which thispermit 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.
r'
it.." t,, If aYa 1 4 tis i r.#, .�
ZONE: BY:
Minimum Setback Distances:. -
Front Setback.from.Center Line
Rear Setback from Rear Prop. Line
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.)
Side Street Setback from.Center Line
Side Setback from Property Line
Lender's Name
F.INAL'DATE
Issued by:
.Validated by:
INSPECTOR
Date 916187 Permit .
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
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE.
r
2ND FL. SQ. FT. ®
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT. ®
GAS (ROUGH)
DR41NAGE PIPING
WALL SQ. FT. ®
OTHER APPJEOUIP.
DRINKING FOUNTAIN
SQ. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER HEATER
SERVICE
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
GRADING
CU. yd.
$ -Plus-X$-=$
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
-
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
GAR. FIREWALL
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/a c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® 3/ac
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 COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE.
r
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
-
CERT. OCC.
FENCE FINAL -
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL