0401-35479683 Arnold Palmer
P.O. BOX 1504 TEL 760=777-7012
78-495 CALLE TAMPICO INSPECTION REQUESTS
LA QUINTA, CALIFORNIA 92253 760-777-7153
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INSPECTION RECORD
OPERATION
DATE INSPECTOR
OPERATION
DATE INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.G.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
POOLS - SPAS
steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location F
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Fina!
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring _
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
IIIIIIIIIIIIIIIII 111111111111 69 T4ht 4
IE
Building •1•
&Mr,-QQ
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
k. 1 -3
No. 10' "
Owner
Mailing
Address
City Zip Tel -
C9?k to(
Address
City Zip Tel.
k-aLra U4
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description
State Lic. City
&CIassif. Lic. # qi'�
Sq. Ft.
No. No. Dw.
Arch., Engr.,
Size
Stories Units
Designer
New [A= Add El Alter [I Repair El Demolition El
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7g) of Division 3 of the Business and Professions Code, and my license is in full force and
effect .
DA7E
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm thal t am exempt from the Contractors License Law for the following
reason: rSec. 7031,5.Business and Professions Cade: Any city or cotinly which requires a
permit to construct, aftef, improve; demolish, or repair any structure, poor to its issuaryce also
taqLams the applicant for such permit fo filo a signed statement that he is Licensed pursuant to
PERMIT
AMOUNT
the previsions of Ifto Contractor's License Law, Chapter "V with SecOon 7000) of
-T.
-afasslon5 Coda or that
avfs�of? 3 of the Gasiriess and P� he I 7Z, therefrom. and The basis
for the alleged exemption- Any violation of Section 70315 by any applicant for
Plan Chk. Dep.
a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500)-
Plan Chk. Bal.
Fl 1, or, 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, BW&ness and
Const.
Professions Code: The Contractors 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,
Mech.
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold wiM0 one year of completion, the owner -builder will have the burden
Electrical
of proving that he did not build or improve for the purpose of sale-)
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
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. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law-)
Grading
El I am exempt under Sec. B. & P.C. for this reason
Driveway Eric.
DateownerInfrastructure
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. 0 Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
Icertify that in the performance of thp 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.
DateOwner
NOTICE TO APPLICANT. ff, after making this Corliffrate of Exemption you should becomZONE:
BY:
subject to the Workers' Compensation piovisio.% of The Labor Code, you must forthwith
comply with such provisionsar this OnVifsh-Wbe deemed revoked.
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTIONLENDING AGENCY
Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
-Side
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lender's Nam
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
FINAL DATE
-INSPECTOR
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct-
Issued by:
Date ins d Permit
I agree to comply with all city and county ordinances and slate laws relating to building
construction, and hereby authorize representatives tof this city to enter the above.
mentioned property for Inspection purposes
Validated by:
Signature of applicant pate
Mailing Address
Validation:
City, State, Zip
A%
3 13
9 a 6 it
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES NO. PLUMBING FEES
1ST FL.
• _
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. ® $
SQ. FT.
SQ. FT.
SQ. FT.
SQ. FT.
SQ. FT.
S0. FT. @
VALUATION $
UNITS
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
I ROOF DRAINS
ROUGH WIRING
DRAINAGE PIPING
ROCKSTORAGE
DRINKING FOUNTAIN
GAS (ROUGH)
URINAL
HEATING (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
GAS (FINAL)
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
BOND BEAM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL TOTAL FEES
1:
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
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 APP./EQUIP.
REIN F. 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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
IIIIIIIIIIIIIIIIIIIIIIIII 70 ' Qum
IE
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address '79-683 LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address f 'OJ , 7 ClLb rTiVe
City Zip Tel..
Paun, Desert 922"S0 568-23,
Contractor
1,Satl fiartoar4e rind v r r
Address
City jZip ITel.
State Lic. City —
& Classif. 2r X13 Lic. #
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
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 and
effect.
SIGNATUH DATC
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 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 penally of not more than five 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 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 fhe 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 -J
❑ 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
I WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) 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: N, after makfng this Cedlficata of Exempban you should become
subject to the Workers' Compensalion prvvislpms of the Labor Code, you must forthwith
comply with such provisions or 1hispem9l shatt be deemed revoked,
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.)
Lender's 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 information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
conatruction, and hereby authorize representatives sof this city to anter the above•
menlioned property for inspection purposes.
Signature of applicant pate
Mailing Address
City, State, Zip
HARD COPY
No. 002570
BUILDING: TYPE CONST.
A.P. Number
Legal Description
Project Description:'
OCC. GRP.
ry,C. U% 3
Sq. Ft. r•
Size f
No.
Stories
No. Dw.
Units
New Add ❑
Alter ❑ Repair
❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep,
Plan Chk. Bal.
Const.
j
Mech.
Electrical
140.73
Plumbing
144-50
S.M.I.
14.51
Grading
Driveway Enc.
Infrastructure
2,00.00
TOTAL
3,665.02
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 Permit
Permit
Validated by:
Validation:
A 6 3 1 3 9 10 Sob2 CK
CONSTRUCTION ESTIMATE
GROUND PLUMBING
NO. ELECTRICAL FEES —
NO. PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR,
CARP.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. ®
SQ. FT.
SQ. FT,
SO. FT. p
SQ. FT.
SQ. FT. ®
SQ. FT.
VALUATION
$
UNITS
HEATING (ROUGH)
STORAGE TANK
FORMS
YARD SPKLR SYSTEM
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP/EQUIP.
DRAINAGE PIPING
GAS (FINAL)
TEMP. POLE
DRINKING FOUNTAIN
GROUT
URINAL
$
FINAL INSP.
I WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
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.
Q. FT, REBID ® 11/4 c
SEWAGE DISPOSAL
FINISH GRADING
SQ.FT.GAR ® J/ac
HOUSE SEWER
FINAL INSPECTION
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE MECH.FEE
PL.CK.FEE CONST. FEE ELECT. FEE
T SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
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 APP/EQUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S 3IGNATURE571 Ni71ALS
GARDEN WALL FINAL