08950 (RC)P.O. BOX 1504
Building 78-105 CALLE ESTADO N o
LA QUINTA, CALIFORNIA 92253i�-
Address783I3 Hislibiway III f#_p
Owner
Owls and TAnda Nevis s BUILDING: TYPE CONST. St4 OCC: GRP. B-7.
Mailing
Address A.P. Number
City Zip Tel.
ALegal Description.
Contractor Project Description X2) 15 if kntssr4nr tlIohP_vr4rwev
Address > •-
City Zip Tel.- ,
State Lia City
& Classif. Lic. # Sq. Ft. No. No. Dw.
`
Arch., Engr., Size 975 Stories I • Units fl
. ••
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
Prior to final Inemetim fire marshall must
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 Estimated Valuation
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 AMOUNT
requires the applicant for such permit to file a signed statement that. he is licensed pursuant to - PERMIT
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 Plan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). -
O 1, as owner of the property, or my employees with wages as, their sole compensation, will Plan Chk. Bal. 19.75
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. f M
Professions Code: The Contractor's License Law does not apply to an owner of property who 15.00
builds or improves thereon and who does 'such 'work himself or through his, own employees, Mech.
Provided that such improvements 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 Electrical - '
of proving that he did not build or improve for the purpose of sale.)9.00
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
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, andlwho contracts for S•M.I,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law:)
El am exempt under Sec. B. & P.C. for this reason ` Grading
J , g /;y Driveway Enc.
Date e;,//--,/% A Owner 7 / �A�1 7, 7L i f s � Infrastructure
y r
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.
TOTAL 33,A3
CERTIFICATE OF EXEMPTION FROM REMARKS _
WORKERS' COMPENSATION INSURANCE -
(This section need not be completed if the permit is for one hundrerdo)lars ($100) valuation ' �O` �,'- ]�Tj,'' �• ' f"x '3t, r�Z
or less.)
I certify that in the performance--of,th9,work for whichfjt:is,permit is issued; I, shall not
employ any �
person in any mann f'so sato--become subject to theiWorkers' Compensation
Laws of lifor ia. . a t
Datd2Owner
NOT 'TO• f(PPLCANT: If, ,iter .makin'g this Certificdti 'bf- Exemption` you shoull'become ZONE: BY:
sub e t to a Workers' Com enation provisions' of 'the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from.Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
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.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, 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 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 Address Validation:
City, State, Zip
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 SQ. FT. ®
SQ 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
COLL. AREA
FLOOR DRAIN ,
MECHANICAL FEES
t
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL * FLOOR SUSPENDED
ROUGH WIRING 01
`
LAUNDRYTRAY
AIR HANDLING UNIT CFM
DUCT WORK
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
WATER HEATER
SQ.FT.GAR ® 3/ic
HOUSE SEWER
FINAL INSP.
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 01
`
! G
fn
V�
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
FINAL INSP. 0
Ou
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FRAMING o �L
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING qfoldto Lo
W
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
4
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
OF
7
T
.0
Ila ..'Outut.
�0 U t t n a n
,Adfjot.�.; t h t e to It
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building• construction or use.. For the following.
BUILDING ADDRESS '787315'o_HWY111
Use Classification Office Bldg. Permit No. 8950
jn
B2cps
Group • Type Construction Fire Zan Use Zone
41830'Fronthall.-Road,
Owner of Building Chris -& Linda Nevins..., !7
City Bermuda Dunes, CA 92201
BY
LonnieDay
October 21, 1991
&
PMoS
PLACE'
Building Official Official
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