06176 (SFD)P.O. BOX 1504 N Q . 06176
Building„� 7&105 CALLE ESTADO
Address 7$""930 Aurare -gnY LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Starlight Dwws Partnership BUILDING: TYPE CONST. OCC. GRP.-
Address P. O Box 329 w A.P. Number Trnrt 24777'1
City Zip Tel. J
La Quanta 92253 564--222$ Legal Description
Contractor Project Description -Lot 15, Model PB Phoenix
Rick Johnson Coustructiou
Address
CityZip Tel.'
State Lic. City
& Classif_ 397169 Lic. # 202 Sq. Ft. 3332 No. « 2 No. Dw.,
Arch., Engr_,
Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
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Zip State
Lic. #
{ LICENSED CONTRACTOR'S DECLARATION
-I he affirm that I am licensed under provisions of Chapter 9 (commencing with Section
' 7000) of Div4slon 3 of the Business and Professions Code, and my license is in full force and
effect I!L"^1�y\\ ' 1---?�-'f"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,Business and Professions Code: Any city or county which requires a
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17
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IEstimated Valuation 4171,731
Permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to tole a signed statement that he is licensed pursuant to
the provsions of the Contractors license Law, Chapter 9 (commencing with Section 7000) of
PERMIT
AMOUNT
Dwision 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 appicant to a clivi penally 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. Dep.
Plan Chk. Bal.
$
Const.
$g 1.s�
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractors License Law does not apply to an owner of property who
burilds of improves thereon and who does such work himself or through his own employees,
that such improvements are not intended or offered for sale. If, however, the building
Mech. • •'
60.0provided
Electrical
�,$ f$
' or improvement is sold within one year of completion, the owner -builder will have the burden
of proving Oral he did not build or improve for the purpose of sale.)
Plumbing
144,50
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
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1z.aa
such projects with a contactors) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Grading
Driveway Enc.
J(' ) ., �•
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
r i -h 1 j 1 -7' A k
7'
I hereby affirm that 1 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.
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TOTAL '`?ml L
45480&52—
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(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 not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of CAROMa
REMARKS
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I
,
elf Y �• . s�
Date Owner
NOTICE TO APPLICANT: h after makig this Certificate of Exemption you should become
subject to the t►bmlers' Compensation provisions of the Labor Code, you must forthwith
oonpy with such Provisions Of tris permit shah be deemed revoked.
ZONE: BY:
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.)
Side Setback from Property Line '
Lenders Name
Lenders Address
FINAL DATE
INSPECTOR
r
8/14/89
7
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
certify that I have read this application and state that the above information is correct.
1 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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. 0
FORMS
SEWER OR SEPT C TA K�:zkROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)? //d O METER LOOP
r
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ plus x$
_$
URINAL
SQ FT ®
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING �3
MESH
INSULATION/SOUND gv
FINISH GRADING
FINAL INSPECTIONC C
CERT. OCC.
Quirt ciun�
2 D
/
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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
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 ® 11/4 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 `� .4 ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBIN UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPT C TA K�:zkROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. 3
GAS (ROUGH)? //d O METER LOOP
r
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. O L
FRAMING 'ti1 % FINAL INSP. MeryG
i L
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING �3
MESH
INSULATION/SOUND gv
FINISH GRADING
FINAL INSPECTIONC C
CERT. OCC.
Quirt ciun�
2 D
/
REMARKS:
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL