07190 (MFD5)Buildin
Address 78-269 Warlet Court
Owner
Boulevard Devetooen
T4 -ht 4 4 Q"
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address 777 S. Main Street Suite 106
City Zip Tel.
Orange CA 92696 714.547-8056
Salmi
City
State Lic.
& Classif. 461814
Arch., Engr.,
Designer
Address
City
Zip Tela
No. 07190
11LDING: TYPE CONST. & OCC: GRP.:
P. Number 613-790-012
Legal Description_
Project Description
BLD #29 Unit #2V9
Plain 3U
Lic. # Sq. Ft. No.
Size 7.63. Stories
Tel.
Zip (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION r
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3,ofjthe Business and Professions Code, and myflicense is in full force and
effec4'f ti f r� '.
T; s.
_SIGNATURE 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, after, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to 81e 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 civit penalty of not rare than rive 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, Bussness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or knproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. d, however, the building
orimprovement is sold within one year of completion, the owner-buDder will have the burden
of proving that he did not build or inprove 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
1 hereby affirm that I have a certificate of cAsent'to self-insure,`or a certiffcate ofr
Worker's Compensation Insurance, or a certified copy thereof.."(Sec.;3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city. ❑ Certified co
0j
jis heretiyfu
cs`
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i1 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 manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT. h, 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.
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.)
Lenders Name
Lender's Address
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 I have read this application and state that the above infprmation 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
New ❑ Add ❑ Alter ❑
uatlon
No. Dw.
Units
Repair ❑
Demolition ❑
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
S
Const.
4A
%_
Mech.
`+
Electrical
02,67
Plumbing
S.M.I.
3e�J
Grading
Driveway Enc.
Infrastructure
1,279. 94
TOTAL
REMARKS
I, t., €+ '? 40 `tt A 7 A4- I R.-4?4 110
ItJ Y OSO 1. jt tldi. k 4f4o.:10
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 I SP %TOR
Issued by: Date -Permit
Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
0
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF. 9jf
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
WALL SO. FT. ®
WATER HEATER SERVICE
DRINKING FOUNTAIN
FINAL INSP.
URINAL
SQ FT ®
WATER SYSTEM
$
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING ' 6
`
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
LAUNDRYTRAY
AIR HANDLING UNIT CFM
I
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/. c
SEWAGE DISPOSAL
INSULATION/SOUND
SQ.FT.GAR ® 3/ic
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
GROUND PLUMBING 00 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
0
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 9jf
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.121q 90 4j)
FRAMING ' 6
`
FINAL INSP.
ROOFING
I l
U
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE/�—
SPARK ARRESTOR
GAR. FIREWALL
LACING S
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION j '�L0
l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL