07172 (MFD5)Building 78-221 Scarlet Court
Address
Owner
Address
City .
.Address
Zip
C&h
P.O. BOX 1504 N Q , -07172
-78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA -92253 .
BUILDING:, TYPE CONST. OCC: GRP.
�Sutite, 106 A.P. Number 613-794-012
Tel. + BLit 131 Uri t ,#303
r. t
714.547-805 Legal Description
Project Description ' Plan 20
Laws of California
City
Zip
Tel.:
State Lic.
& Classff. 461814
City
Lic. #
-
Sq. Ft. 912 No. No. Dw.
Size -- Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑ Alter ❑ Repair. ❑ Demolition O
Address' '
Tel.
r
City
Zip
State
Lic. #
-
r
•' LICENSED CONTRACTOR'S DECLARATION
I hereby affirm t6t4 am licensed'under Provisions of Chapter 9 (commencing,w th Section
700 of Division 3 ofthPrBUSifless and'Professions Code, andmylicense'is in'full force and
-
I hereby affirm that there is a construction lending agency for the performance of the '
'-`work
SIGNATURE -/'� -"x"• �-. _, _ -'_ DATE
+v�ci OWNER -BUILDER DECLARATION
I hereby affirm that 1 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, after, improve, demolish, or repair any structure, prior to its issuance also
• requires the applicant for such permit to rite a signed statement that he is licensed pursuant to
the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) o/
• Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation o/ 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 o/ property who
and who does such work himself or through his own employees,
builds or improves If,
provided that such improvements are not intended or offered /or sale. , however, .the building or improvement is sold within one year o/ completion, the owner -budder 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 whocontracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
• •❑ 1 am exempt under Sec. B. S P.C. for this reason
Estimated Valuation
tms ?Psi
-.• PERMIT` t`Af - AMOUNT
Plan Chk. Dep.' '
Plan Chk. BBI. ' - 3i!)
Const. 486, J
M@Ch: .
EIBCtrICdl `y
' ^
67
Plumbing 12-50
S.M,I, -
^ 62
Grading
Driveway Enc.
Date Owner
Infrastructure 1.467.57
<o
' WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a;certificate of consent to self -insure, or a certificat of
Worker's Compensation Insurance; or a_oertifieiftopy thereof. (Sec:'3800, LatiorCode'.)
Policy No. Companyf^
❑ Copy is filed with the city. ❑ Certifl&f'Opyi hirebyJumished:-.
r ,
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE '
'(This section need not be completed 7/ the permit is for one Hundred dollars ($100) valuation
or fess.) -
I certify that in the performance of lhp 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
-
`
TOTAL S SM. 56 ,�
REMARKS 45;30 1.13— ;r r 'r; 10
r . rt A rvxrrsa a
_
Laws of California
Date Owner
NOTICE TO APPLICANT. f/, after making this Cerfffrate 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 permit shall be deemed revoked.
Minimum_ Setback Distances:
Front Setback -from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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 Setback from Property Line
Lender's Name -
r
' Lender's Address
FINAL DATE
INSPECTOR
' This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. -
I certify that 1 have read this application and state that the above information is correct." -
Issued -by:
Date • 212,1/9OPermit
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
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
/GROUND
SLAB GRADE `7 �+ �/1�
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT.
GAS (FINAL)
TEMP. POLE
WALL SQ. FT. ®
DRINKING FOUNTAIN
GROUT
WATER HEATER
URINAL
SQ FT ®
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
$ plus x$
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
REMARKS:-
EMARKS:VENTILATION
ILAUNDRYTRAY
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3ihc
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE JELECT.FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBIN3 a /T � ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
PLUMB NG
UNDERGROUND
A.C. UNIT
COLL. AREA
/GROUND
SLAB GRADE `7 �+ �/1�
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. �/v ql%�
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. Q
FRAMING
FINAL INSP.
ROOFING
REMARKS:-
EMARKS:VENTILATION
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
H1NG 7 3 / GT
MESH
INSULATION/SOUN
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL