BLDG (0009-007)78725 Maracas Ct
0009-007
LICENSED CONTRACTOR DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professionals Code, and my License is in full force and effect.
License # Lic. Class Exp. Date
X 439904 C10 CZ9 1tU
Date Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( ) 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, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performpee of the work for which this permit is issued.
(ve and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier STATE 1' MD Policy No. =326-N
(This section need not be completed if the permit valuation is for $100.00 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, and agree that if I should become
subject to the workers' compensatio prov* of Section 700 of the Labor
Code, shall forthwith comply with th
Date: rI Applicant
Warning: Failure to secure Workers' mpensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
BUILDING PERMIT PERMIT# ,
DATE VALUATION LOT OOM '0% TRACT
09/10WK $3,12100
JOB SITE APN
ADDRESS 7a-iS iaAE" ar
OWNER CONTRACTOR / DESIGNER / EN (NEER
78.725 WRACAS f;C)T71IS 82.231 EAS':FIlI 0 C:'T.
L.6.QU.ENTA CA, 5122.53 DW10 CA 92201
(760)347-0399 C:BLA 3225.
USE OF PERMIT
0MRIL&T,. DU`ADING
12S LF, 6'1:1 { "LLIEN WALL . ORCO STANDAR) ONLY
6 TY7. WALL
125,00 LF
ESITANATED COST OF C.OiVSt'FZTfMON 31125.00
MMIT FEE fiUM:11hfAIRY
CONOTRUCTION FEB 101-000-4)8-000
SM -TOTAL CONSTR.ITMION AND PIAINT GHEMCI $63.00
LESS Me-PAIDF-M $0.00
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State- laws relating to the building
construction, and hereby authorize representatives of this City to enter upon
the above-mentioned property for in ction pure se
-- RECEIPT DATE
Signature (Owner/Agent) _ Dateqqd
TOTAL I°IQMr FET -5 DUE NOW 1 $6-3100
W•/ cfxs, /1
FINALED rINSPECTOR
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.O.
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
C1 — 1:1 —.uo
Main Drain
Bond Beam
9 ?S— oa ST
Approval to Cover
Equipment Location
Underground Electric
Underground PI . Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
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 Voftage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
COMMENTS:
T4ht 4 4 Q"
Building
Owner
Damon Dev.
Mailing
Address 68-713 Perez Rd.
City IZip ITel.
Contractor
L
Address
State Lic. City
& Classif.337077 Lic. # 1219
Arch., Engr.,
Designer
Address Tel.
City IZip I State
r Lic. #
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
7lXI of Di 3 of _ Business and Professfpns Code, and my license is in full force and
SIGNATURE `—i'+ 1 l r T'DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,13rsiness and Professions Code: Any city or county which requires a
Permit to construct, alter, irprove, demolish, or repair any structure, prior to Its issuance also
requires the applicant for such pem•t to ft a steed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter9 (commencing with Section 7000) of
Division 3 of the Business and PfWessions Code, or that.
he is exempt therefrom, and the bast
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civi penalty of not more than five hundred dollars (S500).
❑ 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 safe. If, however, the building
or improvement is sold within acre year of completion, the owner -builder will have the burden
of proving that he did not build or irprove 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 buids or Improves thereon, and who contracts for
such projects with a cordractar(s) licensed pun uant to the Contractor's License Law.)
❑ 1 am exempt under Sec_ w. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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 fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be conpleled B the pemrt 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: 8, after making this Certificate or Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shah 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, CIO Code.)
Lender's Name
Lenders Address
This is a building permit when property 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
No.
BUILDING: TYPE CONST. OCC: GRP,
Number
05945
Legal DescriptionlIb"g 7ZI Lot 10
Project Description ilam 2222 Parc Let Ouinta
Sq. Ft. No. No. Dw.
Size 2222 Stories Units
New',M Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation 112,1fi1.f10
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
•
Const.
585.00
Mech.
f3u.1ju
Electrical
.
Plumbing
.
S.M.I.
Grading
Driveway Enc.
Infrastructure
•
TOTAL
• .*,f ,( ;:
REMARKS
IV,, ' 14"lit S ii f'
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 6~16—$9Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL AREA
SLAB GRADE
f/ l "
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
F RMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GAS (FINAL)
WALL Sp. FT.
DRINKING FOUNTAIN,
SQ Fr ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
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
REMARKS:
A� ` //1/'/f
` �� _�
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
t
SO. Fr. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11A c
SEWAGE DISPOSAL
SQ.FT.GAR ® Vbc
HOUSE SEWER
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 a /J>UMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE
f/ l "
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
F RMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
ND. REIN
GAS (ROUGH)/'�
t
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.
r
FINALINSP.�—;�
FRAMING
�/
G AL INSP 7E;�J
V
ROOFING
49Y o '
N• w v
REMARKS:
A� ` //1/'/f
` �� _�
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
I SULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
t
GARDEN WALL FINAL