06999 (SFD)Address 56-525 RiV#
Mailing
Address
C&hf 4
P.O. BOX 1504 No. 06999
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253 , / r
--71BUILDING: TYPE CONST., OCC. GRP.
City lZip I Tel.
Contractor
Address
Tela
State Lic. I City
& Classif. 288130 Lic- # 398
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7ggg) 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 affign that 1 am exempt from the Contractor's License Law for the following
reason:_ (Sec. 7031.5,9atness and Professions Code: Any city or County which requires a
permit to consftct ata, improve, dernoksh, or repair any structure, prior to its issuance also
requires the applicant nt for such permit to file a signed statement that he is licensed pursuant to
the Provisions Of the ConfracPor'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 exenptibrr. Any viatation of Section 7031.5 by 'any applicant for a permit
subjects the appirdm to a ciYt palally of rat more than rove 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 Contractors License Law does not apply to an owner of property who
txdMs or irproves thereon and who does such work himself or through his own employees,
Provided that such Improvements are not intended or offeredfor sale. If, however, the building
or improvement Ls said *WA ane year of completion, the owner -budder will have the burden
Of proving that he did not brad or improve 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, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who bunds 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 w, & P.C. for this reason
Date Owner
WORKEW COMPENSATION DECLARATION
Worker's hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
O Copy is filed with the city- ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be corrp/eted if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manna so as to become subject to the Workers' Compensation
Laws of California
(late Owner
N077CE TO APPLICANT: t, after making this Certificate of Exemption you should become
subject to the Mbrkers' Compensation provisions of the Labor Code, you must forthwith
campy wrth such provisions Of this Permit shall 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, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I car tity 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 _ - --
A.P. Number
Legal Description Tract 24ROI
Project Description _Phasp? 14 — PInn Ott A
Sq. Ft. 2353 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
726.84
Const.
888.00
Mech.
71)
Electrical
113.47
Plumbing
156,50
S.M.I.
1
Grading
Driveway Enc.
Infrastructure
*jujb.b
I.A 5 1.1" ed t
Intra We
v!#/.bu
TOTAL
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 2/9/90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADES— _
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL Sp. FT.
FORMS
OR SEPTICTANKROUGH
WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SD. FT. ®
LSEWER
d -AS (ROUGH)— /�
VVV
METER LOOP
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SD. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
RAMING 6—/3—�
FLOOR DRAIN
MECHANICAL FEES
r /l
G✓ v 6 .� f0
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SULATION/SOUND — 0 -
SQ.FT.GAR ® V4c
HOUSE SEWER
FINISH GRADING
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
OUND PLUMBING/
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADES— _
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
OR SEPTICTANKROUGH
WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF. / v
J
LSEWER
d -AS (ROUGH)— /�
VVV
METER LOOP
HEATING (FINAL)
OTHER APPIEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
aFINAL INS P./(�/
RAMING 6—/3—�
FINAL INSP.
ROOFING � I —OL 1)%O�
r /l
G✓ v 6 .� f0
�r O d
�L /�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
SULATION/SOUND — 0 -
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL