AR (3938)54190 Avenida Martinez
03938
'K 1 3
P.O. BOX 1504
Building r 78-105 CALLE ESTADO
Address MarUmat LA QUINTA, CALIFORNIA 92253
I hereby affirm that there is a construction lending agency for the performance of the
Owner
work for which this permit is issued. (Sec. 3097, Civil Code.)
Mailing . D W'OX
Address P. 4. BOX 144 ' _ .
BUILDING: TYPE CONST. OCC. GRP.
7174.222 -007`
A.P. Number
City lZip Tel.
La Qi .1 'fid 9225' 564-9166
Legal Description
Contractor
A & M iroi71strruction
Project Description
... i
E d{ .$ .L P
Address
m.
3--525 JuarezCity
J LI C78
1+4Quint& Zip 922513 Tel. 564t4832,
Issued by:
Date Permit
State Lic.
& Classif. 487$94
City
Lic. #
Sq. Ft. 100
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Signature of applicant Date
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
yLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I a(fiolicensed undettprovisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Profes
effect. sions-Gude, and my license is in full force and
k ,r *"
SIGNATURE _. DATE
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 penalty of not more than live hundred dollars ($500).
01 1
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.)
Estimated Valuation
! 490
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$32.62
COr1St.
.
Mech.
0 U_ U
'
Electrical
:% •'UI
U.
Plumbing
0 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
S.M.1.
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 No. Company
❑ Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
(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 notf ,;
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
ntr .•.a.• +.. ...r.
_
4 eNTuttilF ' 41!4rii
Date Owner
NOTICE TO APPLICANT: Il, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwithMinimum
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY:
Setback Distances:
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
INS t/rip
This is a building permit when properly filled out, signed and validated, and is subject to
m.
expiration if work thereunder is suspended for 180 days.
J LI C78
1 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 -of this city to enter the above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GDL0EN0QD • &SSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
• r
NO. PLUMBING, FEF&
IST FL SO FT (a S
UNITS
�.
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. C
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FTa
GAS (ROUGH)
METER LOOP
GARSO. FT. Qt
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO FT. 0
GROUT
WATER HEATER
WALL SO. FT. @
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. ra
_ S
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ERIAUTOXDISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING .
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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. g c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1'A c
SEWAGE DISPOSAL
SO.FT.GAR a 1i:c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE aL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 8 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.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. y0.
$ -plus-x$
_ S
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 z/a4
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
. a.
5 CITY OF LA
QUINTA
°+or DEPARTMENT>OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Owner T . Bower
. .. .. ".• . •.•... A & M ..,Constructi
Contractor on
Permit Number 3938
V POST ON JOB IN CONSPICUOUS PLACE -
INSPECTOR MUST SIGN ALL APPLICABLE SPACE
JOB ADDRESS 54-190 Martinez
"Room Addition" 4
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
t FOOTING STEEL / i:•: ,,'
MAIN GROUND SYSTEM
GROUND PLUMBING'
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ABOVE HAS BEEN SIGNED '.
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
i
Pik DO NOT POUR CONCRETE UNTIL ABOVE HAS BEEN SIGNED
4 ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS &-GAS T T
HEATING & VENT -"A/C
FIREPLACE
ROOF
BONb BEAM" r:.
O.K. TO WRAP
GROUT ❑ 4' ,❑ 8'
FRAMING'"
r INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS B19EN" NED
RYWALL "INTER OR
XTERIOR LATH
POOL PRE PLASTER i
POOL FENCE & GATE
SEWER -SEPTIC TANK
FINALES
•,_ELECTRICAL
PLUMBING
t FINAL GAS TEST ,
HEATING - A/C
iiOUSE NUMBE.tS F
JOB COMP ">
ABOVE- 0ROVALS DO NOT INCL ', E RIGHT•TO
•`; : TURN ON UTILITIES OR OCCUPYILDING
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Ci4i'fY OF UA QUNTA
0, 43PARTMENT
"ACRON
SUBjEC7'10 UNITALLATiON AS PER
AND ALL APJILICABLE
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