07062 (GAS)P.O. BOX 1504 No. 07062
Building 78-401 Highway 111, Suite $ 7&105 CALLE ESTADO
Address La QuLut4 Shopping Center LA QUINTA, CALIFORNIA 92253
Owner
=� Bt 1LDINGE TYPE CONST. OCC: GRP.
Mailing
Address 88q.` - . A.P. Number La Quinta P3aas Shopping Center
City Zip Tel. - -
Legal Description
r
Contracto
- Degett .A/C Inc.Project Description soak-tw spec for LaQuintse Plaza
Address tesiaat `"
590
Road
City Zip Tela
Palm Springs 1 32264 32373383 .
State Lic. City
& Classif.���r�S� Lic. # �� Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add 0 Alter O Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S,DECLARATION
1 hereby affirm: that 1 am licensed under provision` of Chapter 9 (commencing with Section
effect.7000) of Division 3 offtthe Business and Professions and my license is in full force and
SIGNATURE 1. - DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractors License Law for the following �w •+ eCA�y tr��A
reason: (Sec. 7031"5,Business and Professions Code: Any city or county which requires a al3jEJ•lit
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License taw, 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 penally of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COrISt.� •
Professions Code: The Contractor's License taw does not apply to an owner of property who
builds or "reproves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building Mech.
or improvement is sold within one year of completion, the owner -budder will have the burden Electrical
of proving that he did not build or improve for the purpose of sale.)
❑ 1, 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, and who contracts for S.M.I. .03
such projects with a conlmctogsJ licensed pursuant to the Contractor's License Law.)
Grading
• ❑ 1 am exempt under Sec" B. 8 P.C. for this reason
Driveway Enc.
Date owner Infrastructure
z WORKERS' COMPENSATION DECLARATION
I hereby affirm that I 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.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCEs�?'
(This section need not be completed ff the permit is for one hundred dollars ($100) valuation c�- � x >r.• py f Y •,;1 2 4 • +•m y' ;V 4 t;
or less") a �. . -.. ...... .
I certify that in the performance of Ihp 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: ff, alter makig this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation 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
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued" (Sec. 3097, C" Code.) Side Setback from Property Line
Lenders Name
Lenders Address FINAL DATE INSPECTOR
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. 211 tR�
I certity that I have read this application and state that the above information is correct. Issued by: Date ! 7 Permit
['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
1ST 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
FOR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT.
GROUT
WATER HEATER
WALL SQ. FT. @
+
DRINKING FOUNTAIN.
SQ FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
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
VENTILATION
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-x$-=$-
lusx$=$ROOFING
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL