002405 (WALL)54925 Avenida Alvarado
IIIIIIIIIIIIIIIIIIIIIIIII 454
IE
P.O. BOX 1504 No. 002405
Building U-925 AlAas"33dr 1. Alv 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Amaricim 091MMI
_
Mailing
Sq. Ft. No.
Size 100 .t. .. ft.Stories
No. Dw.
Units
Address
4 -'+--VO M113W TMU
city
Zip
. 3-fWt high ham'
=taiMM Mu
92
ITO92260_ 340"0172'.
Contractor
Estimated Valuation
- .. • 4(
y //
0 0
PERMIT
L e c ncMte
Plan Chk.. Dep. -
Address
Plan Chk. Bal.
Side Street Setback from Center Line
Const._
9292 N&iJ0 Drive
Mech.
City . _
_.... Zip
Tel...
Plumbing
922—W
363—V29 2
State Lic.
Grading
City
& Classif.
4412743
Lic. #
Arch., Engr.;
rt,rryC
AV VV Permit
Designer
Issued by:
Date •
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
effectivisX
. - J'', , - .10— e l/.: .
SIGNATURE -- - DATE
t '
'OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 703 1.5, Business and Professions Code: Any city or county which requires a
-'permit to construct, aRei, 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 penalty of not more than five -hundred dollars ($500).
❑ 1,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
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 the purpose, of sale.) .
O 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. • -B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that Ihave 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
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 777-7#2 -M
Legal Description T*-*- 1-011
Project Description
employ any person In any manner so as to become subject to the Workers' Compensation
Laws of California.
Sq. Ft. No.
Size 100 .t. .. ft.Stories
No. Dw.
Units
New ❑k: Add ❑ Alter ❑
Repair ❑ Demolition ❑
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you • should become
ZONE:
BY:
. 3-fWt high ham'
=taiMM Mu
Distances:
-5
-
Estimated Valuation
- .. • 4(
y //
0 0
PERMIT
AMOUNT
Plan Chk.. Dep. -
CONSTRUCTION LENDING AGENCY
Plan Chk. Bal.
Side Street Setback from Center Line
Const._
Mech.
work for which this permit is issued. (Sec. 3097, Civil Code.) _
Electrical '
Side Setback from Property Line
Plumbing
S. M. 1.
_ Sfl
Grading
INSPECTOR
Driveway Enc.
Infrastructure
expiration if work thereunder is suspended for 180 days. --F
I that I have
rt,rryC
AV VV Permit
certify read this application and state that the above information is correct.
"
Issued by:
Date •
I agree to comply with all city and county ordinances and state laws relating to building
TOTAL
41-75%
REMARKS
mentioned property for inspection purposes.'
Validated by:
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
ZONE:
BY:
subject to the Workers' Compensation provisions of the Labor Code, you 'must forthwith
Minimum Setback
Distances:
comply with such provisions or this permit shall be deemed revoked.
-
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
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. --F
I that I have
rt,rryC
AV VV Permit
certify read this application and state that the above information is correct.
"
Issued by:
Date •
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 `.''y - r'
Validation:
City, State, Zip
A 5 7 6 2
6 10 41,75 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SO. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 114 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/4c
HOUSE SEWER
LATHING
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
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL 6 �'�
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
ell/
NO BEAM /n
VVV
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR. f I
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 SIGNATURES/INITIALS.
GARDEN WALL FINAL