09145 (BLCK)Tdwt
4'14
u�G`GrCu
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 6+-800 Hi . h.land Palms LA QUINTA, CALIFORNIA 92253
Owner
Address 46-840 Highland Palms
CityZip Tel.
.. La Quinta 92253 ' 1564-
Contractor
No. 09345
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description Plac:itia a Garden trance and .
Address
rmit t
me ma i�m-nuir am me i'Droopriy ian
City
Zip
Tela
State Lia
City
& Classif.
Lic. #
Sq. Ft. No. No. Dw.
Size 116 -Stories Units
Arch., Engr.,'
Designer
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
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
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'
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicantforsuch permit to file 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 five hundred dollars ($500).
as owner of the property, or my employees with wages as their sole compensation, will
Estimated Valuation
A� e • AtVvq
7 V
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const. AFS
2� 00
9rthe work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
yProlessions Code: The Contractor's License Law does not apply to an owner of property who
builds or improvesthereonand who does such work himself or through, his own employees,
provided thatsuchimprovements are not intended or offered for sale.,#, 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 improve for the purpose of sale:)
Mech.
Electrical
Plumbing
❑ 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'sLica se'Law.)
❑ 1 am exempt under Sec. B. &,P.G.,(or this reason
f,
,
S•M•1•
Grading
Driveway Enc.
DatevFowner �.•� %''t s�j•�,. ,t {, r
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 acertifiedccertifiedpywhejeof. (Sec. 3800, Labor Code.)
3 {y^^ k± ji- i i . " '� 7' d.+ •rr� .. Sll tee'
an
Policy No. company -
0 Copy is filed with the city. ❑ Certified copy is hereby furnished.
•j „
TOTAL 25. ID -
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE �_j -
REMARKS
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) '
I certify that in the performance`ofork for which t is -perm t is issued, I shall not
employ any person in any manner -so as°to become subject to the'Workers' Compensation
Laws of California. p
Date
NOTICE,FT FAPPLI�ANT: 1 afterL makmg,'hls.%Ceitif ate of 'Ex e ption you should become
subject :to the Workers' ompensationjprovllsions of' the L 4 code, you must forthwith
comply with such provisions or this p�trshalfbe deem ed revoke j
{
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is'a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Lenders Address
This is a buildin h I fill d
g pe w an proper y e ou , signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: —Date
—
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of thin city to enter the -above-.
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
' t
Permit
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL: SQ. FT. ® $
. 2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SLAB GRADE
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
ROUGH WIRING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FOUND. REINF.
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 ® 11/4 c
ISEWAGE DISPOSAL
SQ.FT.GAR ® 34c
HOUSE SEWER
BOND BEAM
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 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 p d
FINAL INSP.
ROOFINGr
P/`
r/ [
IL
,d�m
S
( [w�� ^I�
[ll
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOU
FINISH GRADI
FINAL INSPECTION,?,/ lL
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL