06210 (SFD)Buildin
Address 78-•890 amara Way
Owner
StsrliOt Dues Part
Mailing
Address P. U. Box 329
City lZip
Lt Ninta 92253
Contractor
State Lic.
& Classif. 397169
Arch., Engr.,
Designer
Address
c&ty/ 4
P.O. BOX 1504 N o .
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
1 ;01
06210
BUILDING: TYPE CONST. OCC. GRP.-
A.P. Number Tract 23773
Tel.
564,-2228 Legal Description
Project Description Lot 11, Yodel P$ Phoenix
ion
Tela
Lilcy# 2023332 2
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Tel.
LIG. ff
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section /
e700[n of Division 3 of the Business and Professions Code, and my license is in full force and { ; { > k / h it
SIGNATURE DATE , . 1 t. r ! r~ I'f r ` A
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a
Estimated Valuation
PERMIT
Permit to construct, ager, irprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License law, Chapter 9 (commencing with Section 7000) of
Front Setback from Center Line
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
Plan Chk. Dep.
subjects the appficant 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
-
Plan Chk. Bal.
Const.
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
Mech. -�
builds or improves thereon and who does such work himself or through his own ernpbyees,
provided that such irprovenwis are not intended or offered for sate. n, however, the building
or irprovement is sold within one year of cornpletron, the owner -builder will have the burden
of proving that he acid not build or improve for the purpose of sale.)
Electrical
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"
I does not apply to an owner of property who builds or irproves thereon, and who contracts for
t4 S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
C ❑ I am exempt under Sec B. 8 P.C. for this reason
Grading
Driveway Enc.
Date Owner )
WORKERS' COMPENSATION DECLARATION
L
I hereby affirm that I have a certificate of consent to self-insure�or a certificate of
j 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 it the pemit is for one hundred dollars (S 100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, 1 shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of Califomia.
Date Owner
NOTICE TO APPLICANT: ff, after makirhg this Certificate or Exemption you should become
subject to the Workers' Corrpensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall 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, Ciel Code.)
Lender's Name
Lender's Address
This is abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I cerlity 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 Address
City, State, Zip
$171,731
Y
Infrastructure
TOTAL 1$5,886.
REMARKS
L. 4
AMOUNT
$ 729.75
891.50
50.00
t164.7/%t
144 s 50
12.04
3,$63.95
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
8/14/03
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
�t
SLAB GRADE `�(
2ND FL. SQ. FT. 0
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
GAR. Sq_ FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. SQ. FT.
TEMP. POLE
WALL SQ. FT.
GROUT
DRINKING FOUNTAIN.
FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
FINAL INSP. /�,
vA
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
INSULATIONISOUND3//7
FINISH GRADING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FENCE FINAL
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1//a c
SEWAGE DISPOSAL
SQ.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
�t
SLAB GRADE `�(
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC ANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 23�
AS (ROUGH) l dal
l(I
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP. /�,
vA
FINAL INSP. g Q
V
GRADING
cu. yd.
$ -Plus-X$-=$
REMARKS:
LUMBER GR.
FRAMING J; O
ROOFING
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND3//7
FINISH GRADING
FINAL INSPECTION 3T6 -79e
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1