07129 (RPL)Adddi
rress 78-910 Aurora Way
owner
S3lvem m
Mailing
Address
City lZip
Contractor
Q�rw
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Zip Tela
Palm Desert 32260 344-9000
State Lic. City
& Classif. 185102 Lic. # 335
Arch., Engr.,
Designer
Address Tel.
City (Zip % ti (State I
t' Lic. #
• ! LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that L am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 oUthe Business and Professions Code, and my license is in fulf force and
effect. d' } l / r '.• % i
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,Bushess and Professions Code: Any city or county which requires a
permit to construct, after, irprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such pennif to fie a signed statement that he is licensed pursuant to
the provisions of the Contractors 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 or Section 7031.5 by any applicant for a permit
subjects the applicant to a crW 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 sate. (Sec. 7044, Buisness and
Professions Code: The Contractors 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 krprovements 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 kryxove 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 bre& 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_ a_ & 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. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pemnit is for one hundred dollars (E 100) valuation
or less.)
1 certify that in the performance of thQ 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 California.
Date Owner
NOTICE TO APPLICANT: fl, after malmg this Certificate of Exemption you should become
subject to the Workers' compensation provisions of the labor Code, you must forthwith
comply with such provisions or gds Permit shag 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, Civif Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 100 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
No.
BUILDING: TYPE CONST. OCC: GRP.:
P. Number Starlikbt Dunes
Description
t Description PAoi 6. sva
07129
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
Estimated Valuation
S12,000
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
87.75
Const.
135.00
Mech.
30.00
Electrical
27.00
Plumbing
24.00
S.M.I.
.84
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
A}:ut:iW A11 `l:•,r", iii
1-t7f1 _ )fr
ECt t t1.1tY ! tvmni. x
r
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: Dat,?/22/90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH) 26Q(� ER LOOP
GAR. SQ. FT. Q
POWER OUTLET
ROOF DRAINS
GAS (FINAL) 000'TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax Valuation
FRAMING
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
INSULATIONISOUND
SQ.FT.GAR ® 3/ac
HOUSE -SEWER
FINISH GRADING
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 4®
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) 26Q(� ER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) 000'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
Y` t «IIUJJJJ iy�
r
19
REMARKS:
VENTILATION
FIRE ZONE ROOFING'
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION 91dq( l (_
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESJINITIALS
`
GARDEN WALL FINAL