PAT (08288)79575 Marigold Lane
08288
P.O. BOX 1504 N o .
Building 78-105 CALLE ESTADO
Address 79-575 MARIGOLD LANE LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 79-575 MARIGOLD LARR
City Zip Tel.
LA QUTATA, CA 92253 1 __
Contractor
CUSTOM PLUS BUILDERS
Address
31855 DATE PALMSDRIQR, 0182
City Zip Tel:
rtarsrtftT%0At 1AA,.InAt
State Lic.City
& Classif. #557546 B-,1
Arch., Engr.,
Designer1
Address Tel.
J101J3 AlJAZD+ E1L 10 340- 4VIDJ
City Zip State
CATBEDRAL CITY 9223 Lic. #
LICENSED ACTOR'SDECLARATION
I hereby affirm that.1/a. licensed der proviSi ns of Chapter 9 (commencing with Section
7000) D.ivisi0T0pfah iness_„gd=Prore's n 0ode, and my license is in full force and
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S,Buslness 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 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).
❑ 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.)
❑ 1, as ownerof the property, am exclusively contracting with licensed contractors to con-
struct the projects, (Sec. 7044, Business and Professions Code: The Contractor's License Law
'does not appy>7o 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
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. O 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 fess.)
I certify that in the performance of thg,work`foi whicD.thii 'is issued, I shall not
employ any person in any minner-so.,as'to,become subject to.the Work is' Compensation
Laws of California
• i
Date ''1^2 'caner
NOTICE TO A LI NT: ll, Ker ma ng this Celic`a(euil 'xempt you s u d become
subject to the WorkersCompensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
i
'rJ..., CONSTRUCTION LENDING AGENCY
I hereby affiirn'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 it 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. PATIO OCC: GRP.•
A.P. Number CACTUS FLOWER TRACT
Legal Description
Project Description PATIO (LATTI
Sq. Ft. No. No. Dw.
Size 528 Stories Units
New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
sft_gAi_1n
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I. b
Grading
Driveway Enc.
Infrastructure
TOTAL ARI A2
REMARKS
A v..•.ri . i 1:i9 ... r r " l a
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
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT, ®
CAR P. SQ. FT.
WALL SO. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
SEWER OR SEPTIC TANK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11A c
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® 3/ac
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 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 APPJEOUIP.
REINF. STEEL
tluc
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
r`
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION (,5/q
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
- `- {• • _-_ - "I / ,I - ,lam t +!'r _ .
~' -P.O. BOX 1504 No. 05899
Building : 78-105 CALLE ESTADO
Address 79-575 Msrigold Lane LA QUINTA, CALIFORNIA 92253
,.:Owner .
• La Quinta As"cia les
Mailing , v BUILDING TYP•E'CONST. OCC: GRP.
Address 43•-875 vashington st: A.P..Number..
City Zip . Tel.
P.i?. 22£t? Y` Legal Description lPhase •ZX' -Tot 37
Contractor P „ctL$ r
Project Description CaCtus
E.G. Milliams DE`... :.
Address.
• fttiTdt? • A} _
City Zip Tel::
State Lid. Cit
& Classif. { 493911 Licy# 1233 , :• , Sq. Ft. r No. No. Dw , •' '
SizeStories Units
Arch., Engr.,' '
Designer Newly Add:❑.-' Alter ❑ Repair ❑ -Demtilition.p'
Address;;' ' Tel.
Clty. - r., Zip . State
Lic. #
• .r,; LICENSED CONTRACTORS DECLARATION r
+_
i hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 5
7000) of ivision 3 of the Business and Professions Code, and my license is in full force and
effect •, u • _ r ; 'i " r y
SIGNATURE DATE ,
OWNER•BUILDER DECLARATION Estimated Valuation. g } n
I hereby affign that I am exempt from the Contractors License Law for the following 73,6.,2..79 . V0
;rea,^,orc (Seca 7031.5,BusfteSs and Professions Code: Any city- or county which requires a ,
permit to rhrc. atter, hwrove, demolish, or repair any structure, prior to its issuance also , -
requires me applicant for such permit to We a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contracors license Law, Chapter 9 (commencing with Section 7000) of -1
ri • Oivisicrh 3 of the Business s Codo sect bnm iosl s exempt
y ty Pri%amni otl the
epems Plan Chk. &d 6-
subjects the app.icant to a trod penally of not more than five hundred dollars (5500).
❑ 1, as owner of the Plan Chk. Bal. — -
•do thew ply or my employees with wages as their sole compensation, will '44Q. Qi
work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and•
Const:
' '• _
Professions Code: The Canbactor's License Law, does not apply to an owner of property who • •
.` buft or improves thereon and *who does such work himseff or .through his.own- employees, Mech. 53.
-provided tat such inipmvements are not intended or offered for safe-'U, however, the building -
^• . or ermrovement is said within one. year of completion, the owner-budder will have the burden • Electrical
of provchg that he did not build or erynove for the purpose of sale.) w
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to Plumbing
con-
struct the project (Sec. 7044,-Business and Professions Code: The Contractor's License Law
does not apply to an owner of pmperty who brtds or improves thereon,, and who contracts for S.M.I. - -•
such projects with contractor(s) 6oensed pursuant to the Contractor's License Law.) -
❑ Lam exempt under Sec_ w- & P.C. for this reason
Grading "
Driveway Enc.
Date Carer Infrastructure V 164848
. WORKERS' COMPENSATION DECLARATION 7'. , ' , 75 ti
hereby affirm that I have a certificate of consent,to self-insure, oralcertificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) _
Policy`No Company
-0 Copy is filed with the city. ❑ Certified copy is hereby Iumished. .
TOTAL Gt7v v'`).: ✓?
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE - '
. (Tft section need not be completed if the permit is for one hundred • dollars S 100 valuation - - {,l1"x'l y t § f :f 6 J 4, ) : • • "
'Grim.) ! ) . •`. "+P MTt `ma , it`i... - d ..
' I certify that in the performance of thg work for which this permit is issued, I shall not -r
• ` —play any ppeerson in any manner so as to become subject to-the Workers' Compensation
t Laws of Cal ifwrrhia- '
Date Owner
NOTICE TO APPLICANT d, after malmhg this Certificate of Exemption you should become ZONE: BY:' =
' s 49d to the Wbrlters' C.onvensation provfsraris of the Labor Code,. you must • forthwith i
corrmywahsuch provisions orOtis pemmshall bedeemed revoked . Minimum Setback Distances:
' Front Setback from Center Line'
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
1 hereby affirm that there is a construction lending agency, for the performance of, the
work for which this permit is issued. (sec- 3097, OW code.) Side Setback.from Property: Line
• Lenders Name +
Lenders Address
This'is a building permit when properly filled out, signed'and validated, and is subject to . FINAL DATE INSPECTOR
expiration it work thereunder is suspended for 180 days. 6 .,
I certify that I have iced this application and state that the above informationiscorrect issued by: Date Permit
-
I agree to comply with all city and county ordinances and state laws relating to building y _
`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 -v '.Validation"
City„ State, zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE ?1r(
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. Sp. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
R LOOP
HEATING (FINAL)
DRAINAGE PIPING
CARP. SO. FT. ®
GAS (FINAL) .v 2
G
WALL SQ. FT.
DRINKING FOUNTAIN.
SQ FT ®
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
a
ROOFING r+[ fl
VENTILATION
FIRE ZONE 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
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 ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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 pe
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ?1r(
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
�l 170
GAS (ROUGH) ��
R LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) .v 2
G
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. �Z '
FRAMING
FINAL INSP.
a
ROOFING r+[ fl
VENTILATION
FIRE ZONE ROOFING
REMARKS:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1