RPL (13666) + SATT (13529)79615 Mandarina
13666
14594
13529
07801
P.O. BOX 1504
Building 7 i 5 ?1-t ,y 1Y 4 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner ?, t' _ =iN
Mailing
Address" •IrxZc_t
Tel5.3.4
Canty ctor .
Address
+Zip _ c7' i Tel340._ 00'
State Lic-. , r I City r
& Classif. r 1 .J '.1 Lic. #
Arch., Engr.,
Designer. c:Y'Z•"'?.
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I;hereby affirm that I am liop, . sed under provisions of Chapter 9 (commencing with Section
p 7pOD)
t. of Dlvislon 3 of1be-BUIness and Professions Code, and my license is in full force and
ef}ac
stnNul ,m. DATE
OWNER -BUILDER DECLARATION
I here4y 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 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.)
❑ I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm_hat I have a certificate of consent to self -insure, or a certificate of
Worker's Compefr tion Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
fl pyfiled 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 thg work for which this permit is issued, I shall not
employ anypperson in any manner so as to become subject to the Workers' Compensation
Laws of Cal itomia.
Date Owner
NOTICE TO APPLICANT: H, after making this .Certificate of Exemption you should become
subject to the Workers' Compensallorn provisions of rht! Labor Code, you must forthwith
comply with such provisions or Ihis peNnfl shaU he deemed Fevoked-
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 thereundar 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
construction, and hereby authorize representatives sof this city to enter the above•
mentioned property for Inspection purposes -
Signature of applicant Date
Mailing Address^_
City, State, Zip
N 13666
BUILDING: TYPE CONST- OCC. GRP.
A.P. Number
Legal Description
Project Description
Sq. Ft. No.
Size Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
7 4 : 'A
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear S6tback from Rear Prop. Line
Side Street Setback from Ct nter Line
Side Setback from Property Line
FINAL DATE JUN 2lLs@IftR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SQ. FT. Q $
2ND FL. SQ. FT- @
POR. SQ. FT
GAR. SQ. FT. ®
CAR P. SQ. FT. @
WALL SQ. FT. ®
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION Is
COLL. AREA
UNITS
ROUGH PLUMB.
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
I ROOF DRAINS
SEWER OR SEPTIC TANK
DRAINAGE PIPING
DUCT WORK
DRINKING FOUNTAIN
FOUND. REINF.
URINAL
GAS (ROUGH)
WATER PIPING
NOTE: Not to be used as property tax valuation
OTHER APP.IEQUIP.
REIN F. STEEL
FLOOR DRAIN
MECHANICAL FEES
TEMP. POLE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
BOND BEAM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -Plus-X$-=$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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.
FIRE ZONE ROOFING
SQ. FT. ® c
BATH TUB
FIREPLACE
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SPARK ARRESTOR
SQ. FT. RESID ® 11/4 C
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
INSULATION/SOUND
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE
PLCK.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.IEQUIP.
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
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
eFINAL INSPECTION!j- C/ q
I
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL
4
P.O. BOX 1504 No. 14594
Building79-611578-495 CALLE TAMPICO
Address 79-6115Ma--.-,dars =3a LA QUINTA, CALIFORNIA 92253
Owner -
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address 3501 Jain o ee Road, Ste. 200
A.P. Number
City Zip Tel. L
;v`ewrp,-O;v t Be, C:�: i CA 9 0 6 6 0 5 6 4— X 4 8 r Legal Description �"� `' 22'
ContractorProject Description ` pa ` n l-
C : li. fcir:►ia poops & Spay
ffd-J - Boa. dwa1k A--2
al -m Deserte C� zip 3261 Tel. 34o--wCi00
State Lic. City
& Classif. C-53 135102" Lic. # 355 Sq. Ft. No. No. Dw.
Arch_ r✓ngr.,
Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
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 Divlsfon.3 of theBfisiness and Professions Code, and my license is in full force and
effect.
NAFII DATE
OWNER -BUILDER DECLARATION Estimated Valuation f9 i\
l hereby affirm that I am exempt from the Contractor's License Law for the following $ 6 , 0 _ J • L. [; 0
reason: (Sec. 7a31.5,8us1ness and Professions Code: Any coy or counly which requires a
permit to construct, after. Improve, demolish, or repair any structure, prior to its issuance also
requires the appikanf for such pamid to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provlsrons of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
Division 3 of the Business and Professions Code, or thathe is exempt therefrom, and the basis
for the alleged eremption_ Any violation of SacOon 7031.5 by any applicanf For a permit Plan Chk. Dep.
subjaels the applicant to a civic penalty of nal more thorn five hundred dollars f 8500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal_ 52.155
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 181.00
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, Mech. >
provided thaf such improvements are no[ infended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical y >L}
of proving that he did not build or improve for the purpose of sale.) r
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 27 09
struct the project. (Sec. 7044, Business and .Prolossions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves !hereon, and who contracts for S.M-I_
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure
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 Np.—.: , I pany
Copy is: 1)a -d with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This secflun need riot be corrpkied if the permit is for one hundred dollars fE100) valuation
or Iess.)
I cerilty that in the performance of thV work for which this permit is issued, I shall not
employ any.persgn in any manner so as to become subject to the Workers' Compensation
Laws of Cah ornla
Date Owner
NOTICE TO APPLICANT: 0. alter making this Certificate 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
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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. �Y
I certify that I have read this application and state that the above information Is Correct. Issued by: DatePerfnit s
I agree to comply with all city and county ordinances and state laws relating to bullding
cgnstructlon, and hereby authorize representatives -of this city to enter the above. -
mentioned property for inspection purposes_ Validated by: lI
Signature of applicant Date
Mailing Address_ Validation: `1.4 i295
I
City, State, Zip V
Ry
■L
1 CONSTRUCTION ESTIMATE
1
GROUND PLUMBING
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. C
SQ. FT. @
SO. FT. @
SO. FT.
SQ. FT.
SQ. FT.
SO. FT.
VALUATION
$
UNITS
HEATING (ROUGH)
STORAGE TANK
FORMS
YARD SPKLR SYSTEM
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOUND. REINF,
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
DRINKING FOUNTAIN
TEMP. POLE
URINAL
$
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
BOND BEAM
FLOOR DRAIN
MECHANICAL FEES
GRADING
cu. yd.
$ -Plus-x$-=$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
:SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING
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
FIREPLACE
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
GAR. FIREWALL
SO. FT. Cts c
BATH TUB
LATHING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
MESH
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
INSULATION/SOUND
SQ.FT_GAR ®'Ac
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
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.IEQUIP.
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
INSULATION/SOUND
FINISH GRADING
//,Z/FINAL INSPECTIONS
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
TRY 4 eCP Qawcv
P.O. BOX 1504 N o . 13524
Building w 78-105 CALLE ESTADO
Address 79-615 "i',;.TId: A_Ikia LA QUINTA, CALIFORNIA 92253
Owner �� Co.
�,;.r ic7
BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address
A.P. Number
City; C Zip .. Tel. '.:fit 2" `r"i act
N('1114)
ewPor-Bea k1 CA y e s Legal Description
Contractor Sr.A: Dizplax P13 i 3
Sa_air Project Description
I Address
City Zip Tel.
State Lic. tq,r_t 3i0160City r�d3
& Classif. Lic. # Sq. Ft. 2747 No. No. Dw.
Size Stories Units
Arch., Engr., ; i,�- uS C7r un
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Add`V CorporZl e- Way Tel. (714) _
CityIrvine, Zip State
CA)2-714 Lic.# C'68a5
LICENSED CONTRACTOR'S DECLARATION
I hereb afflrm that I am licensed under provisions of Chapter 9 (commencing with Section
7=) of lylsiorl 3 of the Business and Professions Code, and my license is in full .force and
ffecL - 2 •{
SIGNATURE _ _ DATE_
OWNER -BUILDER DECLARATION Estimated Valuation + ?
I hereby affirm that I am exempt from the Contractor's License Law for the fallowing 4 (i
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which r6qulres 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 PERMIT AMOUNT
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 Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
71I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 7-7
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. ;- ¢ J
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, Mech. 102
provided that such improvements are not intended or offered for sale, If, however, the building 'r
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 17 2. 4
of proving that he did not build or improve for the purpose of sale.) ' „
C1 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 17 4 a :/ h
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 -I_
such projects with a contraclor(s) licensed pursuant to the Contractor's License Law.)
f� ,
❑ I am exempt under Sec. B. & P.C. for this reason Grading 90
Driveway Enc. .00
Date Owner Infrastructure 4 x640.715
its in Public Pl_'tiL^e 29 i . 2 U
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 Na- Company
Japy is fi ed with she city. El Certified copy is hereby furnished.
TOTAL .r ► � 33 � �
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.)
I certify that in the performance of the work for which this permit is issued, I shall not
employany parson in any manner so as to become subject to the Workers' Compensation r -
Laws o1 California. 1
Date Owner
NOTICE TO APPLICANT., If, alter making this Certificare of Exemption you should become ZONE: BY: _
subject to the Workers' CompansaLon provisipns of the Labor Coda, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be doomed 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.
I certify that I have read this application and state that the above information is correct- Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof 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
A.C. UNIT
SQ. FT. ® $
UNITS
ROUGH PLUMB.
BONDING
SQ. FT. @
STORAGE TANK
YARD SPKLR SYSTEM
SEWER OR SEPTIC TANK
SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
FIEINF.
SQ. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APP.IEQUIP.
SQ FT ®
GAS (FINAL)
DRAINAGE PIPING
SQ FT ®
SO. FT. ®
DRINKING FOUNTAIN
SERVICE
URINAL
7 CONSTRUCTION VALUATION $
EAM
WATER PIPING
to be used as property tax valuation
GRADING
cu. yd.
$ plus x$
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
7 FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
DRYER
GARBAGE DISPOSAL
JNIT WALL FLOOR SUSPENDED
REMARKS:
LAUNDRY TRAY
3 UNIT CFM
KITCHEN SINK
SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
Hp
POLE,TEMIPERM
LAVATORY
'TEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST_ FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
K
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
RADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FIEINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
STEEL
GAS (FINAL)
TEMP. POLE
WATER HEATER
SERVICE
FINAL INSP.
EAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
GR.
FINAL INSP.
IG
FINAL INSP.
IG
REMARKS:
o,TION
)NE ROOFING
kcE
ARRESTOR
REWALL
G
TIONISOUND
GRADING
NSPECTION
)CC.
FINAL
INSPECTOR'S SIGNATURESIINITIALS
N WALL FINAL
d
CITY OF LA OUINTA
or ^ s DEPARTMENT OF PLANNING & DEVELOPMENT
: BUILD NG DIVISION
24-HOUR NOTICE FOR INSPECTIONS
777-71g"YJIFIAuU14TA
Owner J.M. Peters Co. JUL 14 144
Contractor Same
Permit Number 13529
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 79-615 Mandarina
Y'
MW Lot 22
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL '
MAIN GROUND SYSTEM j T'
GROUND PLUMBING i
DO NOT POUR CONCRETE UNTIL ALL ABOyg d S 0 ENSIGrJED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
', -
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST .
HEATING & VENT - A/C
FIREPLACE
BOND BEAM
O.K. TO WRAP
i
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS-BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
ELECTRICAL ='
PLUMBING
FINAL GAS TEST
HrATING-A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
,, q 1C
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
088
�' P.O. BOXLLE 504 APPLICATION ONLY
�
Building � !/ 1 n� � , N/�
78 1l
Address L4 '�'/ !'f LA QUINTA, CALIFORNIA 92253
Owner � ,M ++ s � ,
Mailing j, 1 � /f nn /^� BUILDING: TYPE CONST. OCC. GRP.
Address ?j a l �v rt /LL
A.P. Number tog-
Zip Tel. � Z` b 7 — ra
t/�/ y L�U Legal Description —2>_ �/
Contractor 45 ` Project Description S ��(�P iC /�
v
Address 3 0/"
City Zip Tel.
State Lic. / City
&Classif. ?J (� 6 B—! Lic. # Sq. Ft -27,17
No. No. Dw. /y
Arch. ngr., % Size 2 t,( 7 Stories / Units /t
,Designer � S 4 %� New Add ❑ Alter ❑ Repair ❑ Demolition ❑
SS
Ci.Zi State ��j
�Z7/ r� Lic. # t O
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that Iia license under provisions of Chapter 9 (commenci g wiffi Section
7000) of Division.3 0,�� usihegs and Professions Code, and my licens i , fulfttorce and
effect. /1�/+-- / >
SIGNATURE .fey / DATE
r Lk_/ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
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 PERMIT AMOUNT
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 Plan Chk. Dep. UXJ
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
1: 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
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, Mech.
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 Electrical
of proving that he did not build or improve for the purpose of sale.)
I 1 I, 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.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
I 1 I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Co a ai Insurance, or a certifi �rgpy theteof. (Sed . 381 Q,� or
Policy No. Company r/l�/�Jj� L- VA/ U
[I Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'COMPENSATIONINSURANCE
(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
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California. yxm, - - yr,
Date Owner `S1tl Q l r I1JT �. 7.� '1250-00=_
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: tt ►i �.
subject to the Workers' Compensation provisions of the Labor Code, you must forth with
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
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.
1 certify that I have read this application and state that the above information is correct. Issued by: Date Permit
1 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
BUILDING DIVISION
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. a $
2ND FL, SO. FT. (To
POR. SQ. FT. CSS
GAR. SQ, FT,
CAR P. I SD. FT. Gy
WALL SO. FT. (T
SO. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1I c
SEWAGE DISPOSAL
SO.FT.GAR @ 3,c
HOUSE SEWER
REMARKS:
VENTILATION
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.IEQUIP.
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
GARDEN WALL FINAL
run 4 AW NA t untzwiNe i 1ALS
Building
Address 73-615 mandamna
Owner
JR Peters
Mailing
Address 12526 1"Qh 81aff
City rZip
Contractor
Address
Zip
T 0 0
4ht 4 4a Qabtm -
State Lic. City
& Classif. I Lic. #
Arcn., tngr.,
Designer
Address Tel.
City( Zip ( State
k Lic. #
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
h J�LICEVED CONTRACTOR'S DECLARATION
thereby aft rl�t that I drt�lice sed under provisions of Chapter 9 (commencing with Section
7000) of Divi r 7t 3 df Te';BVsi` s and Professions Code, and my license is in full force and
effect. i u f t .i
OWNER -BUILDER DECLARATION
I herebyffirm teat ' 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
Perm"' to con ruct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires,lhe 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 thathe 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).
❑ 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
or proving that he did not build or improve for the purpose of sale.)
❑ 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 or property who builds or improves thereon, and who contracts for
such projects with a confractor(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
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
opy is filed with the city. ❑ Certified copy is hereby furnished.
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., If, 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
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
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
BUILDING: TYPE CONST
No.
OCC. GRP.:
07801
A.P. Number Citrus Contx'Se
Legal Description TRact 24890-2 Plan 3A
Project Description _ _ Lot 22
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 5/4/9BPermit
Validated
Validation:
TJ
Sq. Ft. ,47
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$2W,494
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
1-56,50
S.M.I.
(3
Grading
Driveway Enc.
Infrastructure
_4511.12
TOTAL
s •
{� { 4 r �`
REMARKS
41115191 i -In
x774 07'_113_00
I k144aYt
i Witit_ 1 ffa
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 5/4/9BPermit
Validated
Validation:
TJ
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I SO. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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 ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
99
rjAc'( ,
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 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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
99
rjAc'( ,
VENTILATION
7,7 -615
-
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL