BLCK (08168)City, State, Zip
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Tay/
ry r P.O. BOX 1504,
AA,, •4
48168
Building . 78-105 CALLE ESTADO
>.
Address LA QUINTA, CALIFORNIA 92253
' Owner,,Mty
Rhodes
BUILDING: TYPE CONST. OCC..GRP.
Mailing
Address
144domn Vatijar
A.P. Number
774,132418
City ;;' Zip Tel;.
�ec�
Legal Description
tot7 #dlaek 241 1111�ndt93 }
Contractor;;Project
Description
4CCz�$P(1
Address
-r
City ' Zip Tel.:
a.
State Lic. ' r 1;'...
City
Classif.,':'. al,
Lic. # y-
Sq. Ft.
No.No. Dw. ;
•&
,
Size
Stories Units • �'
Arch., Engr:;.;
..
,'.:
• Designer
New ❑ Add ❑ - , ' Alter ❑-. Repair ❑ •Demolition ❑
Address
Tel.
City
Zip
State:
"
f,
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
• effect.' •.
-
SIGNATURE DATE
"' 'OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm•that I am exempt from the Contractors License Law for the following
•'reason: Code: Any
p�
tiu
(Sec.7031.5,Business and Professions 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
'of.
"PERMIT
- AMOUNT. '
_ the provisions 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
Plan Chk.,Dep.
,
-
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).
Plan Chk. Bal.
0.1, as owner of the property, or my employees with wages as their sole compensation, will
Const. -
`
- •
,do the work, and.the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code:Contractor's., License
.. .The 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
Mech.
'
Electrical
-
• 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.)
Plumbing
' ❑ 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
S. M,1,
A
•tci�' ,
-does not apply to an. owner of, property who builds•or improves thereon, and who contracts for
-such projects with contractors) licensed pursuant to the Contractor's License Law.)
Grading
_
-
❑ I am exempt under'Sec. B. & P.C. for this reason
Driveway Enc.
Date s» OwnerL-"�z"`�pL
`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. ❑ Certified copy is hereby furnished. '
TOTAL -
26.07 1
.. , r
' CERTIFICATE OF EXEMPTION FROM
✓ WORKERS' COMPENSATION INSURANCE
1need-not
REMARKS
-
'^ ..��' { F L
-Li
(This section be completed if the permit is • for one hundred dollars ($100) valuation
ttv �FJY r•� .i. Huta � 25 {7
-25-.07
J, ft-�:e3'7 -3 t _, .�..7 ��! Y
' or less.) -•: , .. _ t
I certify that in the performance of thg work for which this permitAs issued, I shall not '
y i.
employ anyperson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date ,3-''rOwner.
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
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
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.) F
$Ida 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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information.is
a '
6/26/90 Permit 's-
correct.
I agree t0
-Issued by:
Date
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.. IValidated
by:
Signature of applicant Date'
Mailing Address
Validation:
City, State, Zip
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CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
2ND FL. SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH)
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYE14
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
plus x$
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 ® 11/4 c
SEWAGE DISPOSAL
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
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
Afv /10104"1-7 // /A Ile,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL