05378 (SFD).;
P.O. BOX 1504 No. 45378
Building 78-105 CALLE ESTADO
Address 11-a,` A LA QUINTA, CALIFORNIA 92253 I I� D I
Owner 1/
BMRATiON BUILMS INC _..
Mailing .
BUILDING: TYPE CONST. OCC: GRP.
Address P.O. BOX 2401 � A.P. Number 774-243-1309
City Zip Tel.
.>
7sm_ 9220 246:4614 Legal Description
Contractor Project Description'
Address
City
Date
Zip
Tela
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become
ZONE:
State Lic.
& Classif. 352211
City
Lic. # 1230
Sq. Ft.
Size ;A.
No. No. Dw.
Stories Units
Arch_; Engr., "
besigner
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
City
Zip
State
Lic. #
I hereby affirm that there is a construction lending agency for the performance of the
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 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.
work for which this permit is issued. (Sec. 3097, Civa code.)
Side Setback from Property Line
Lenders Name
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirTn that 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,tiiaimess and Professions Code: Any city or county which requires a
permit to constrict, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to tae a signed statement that he R licensed pursuant to
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
`Division 3 of the Business and Professkms Code, or that. he is exempt therefrom, and the basis
for the affeged 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 Contractors License Law does not apply to an owner of property who
builds or rrproves thereon and who does such work himself or through his own employees,
provided that such irpmvements are not intended or offered for sale. Il, however, the building
or improvement is sok/ within one year of completion, the owner -budder will have the burden
of proving that he did not build or rrprove 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.)
O 1 am exempt under Sec B. & P.C. for this reason
Estimated Valuation
>a9+ g�2
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
<9175
Const.
594.50
Mech.
Z - qn
Electrical1,41
,
Plumbing
157.50
S.M.I.
Grading
11%
Driveway Enc.
(<60
i
Date Owner
Infrastructure
1+984.54
WORKERS! COMPENSATION DECLARATION
I hereby affirm that I have a'certificate of consent to self -insure, or a certificate of
Workers 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.
1 CERTIFICATE OF EXEMPTION FROMf
WORKERS' COMPENSATION INSURANCE
(This section need not be campieted ff 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 alifornia
California-
TOTAL
_ ^
REMARKS
t r ,x J rmxm" ' v �'-•' t
4}� 3 :ki `f. : FSCs ,2 . 3 3
Date Owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become
ZONE:
BY:
subject to the Workers' compensation provisions of the Labor Code, you must forthwith
Distances:
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback
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, Civa code.)
Side Setback from Property Line
Lenders Name
Lenders 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 certity that I have read this application and state that the above information is correct.
Issued by:
Date? -/22/89 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•Addr -.
.,;Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST EL. `� SO. FT. a $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
I.
2NU,FL. SQ. FT. ®
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. Sp. FT.
POWER OUTLET
ROOF DRAINS 9
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. FT.
GROUT
WATER HEATER
WALL Sp. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT a
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ®c
BATH TUB
LATHING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® IV* c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
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 APPIEQUIP.
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
INSPECTOR'S SIGNATURES/INITIALS
k.
GARDEN WALL FINAL
t
C&t�p 4 4 Qum'
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
fJN ZA LA QUINTA, CALIFORNIA 92253
Zip ' ITel.
el..
I
State Lic. City
& Classif. 3,r-Lic. # 2 raj D
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
effect
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
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,Busiress 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 permit to fie 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 rive 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 irproves thereon and who does such work himself or through his own employees,
provided that such irprovernents 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 inprove 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 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.)
O 1 am exempt under Sec R. & 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 furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the perm 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
Cali ria ppeerson in any manner so as to become subject to the Workers' Compensation
Laws of
Date Owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become
subject to the Workers' Corrpensation provisions of the Labor Cade, you must forthwith
comply with such provisions or this permit slag 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.)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 100 days.
I certify that 1 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
ateMailing Add
City, State, Zip
BUILDING DIVISION
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number - -t�'%W
Legal Description
Project Description
Building
No. No. Dw.
Stories Units
Address
-
Owner
E
M iling
Address%
n
C&t�p 4 4 Qum'
P.O. BOX 1504 APPLICATION ONLY
78-105 CALLE ESTADO
fJN ZA LA QUINTA, CALIFORNIA 92253
Zip ' ITel.
el..
I
State Lic. City
& Classif. 3,r-Lic. # 2 raj D
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section
effect
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
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,Busiress 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 permit to fie 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 rive 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 irproves thereon and who does such work himself or through his own employees,
provided that such irprovernents 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 inprove 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 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.)
O 1 am exempt under Sec R. & 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 furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the perm 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
Cali ria ppeerson in any manner so as to become subject to the Workers' Compensation
Laws of
Date Owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become
subject to the Workers' Corrpensation provisions of the Labor Cade, you must forthwith
comply with such provisions or this permit slag 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.)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 100 days.
I certify that 1 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
ateMailing Add
City, State, Zip
BUILDING DIVISION
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number - -t�'%W
Legal Description
Project Description
Sq. Ft.
Size ���,/j(j
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
r
Estimated Valuation
�D 2
PERMIT
AMOUNT
Plan Chk. Dep.
a -D
Plan Chk. Bal.
Const.
p
Mech.
0
Electrical
-3 /
Plumbing
O
S.M.I.
O
Grading
p _.Ma
Driveway Enc.
ZA - co
Infrastructure
A/
TOTAL
Q v
REMARKS
005182 10 4766 02•-14-89 10
__r.00
i J
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. [NG FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSft,A
2ND FL. SQ. FT. ®,
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ- FT- ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. @
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP. SQ. FT. ®
FINAL INSP.
'WALL SQ. FT. ®
'
'
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus -x$-=$
URINAL
SQ. FT. ®
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION- $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE - DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
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 ® 1+/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
HOUSE SEWER
FINAL INSPECTION
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 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:
VENTILATION
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