12237 (BLCK)�O ✓ D P.O. BOX 1504 No 12237
Building —SIO HIGHWAY1111 LA QUI 105 COAL CALIALLE FORNIA 92253
Address
Owner NORWEST FINANCIAL
Mailing BUILDING: TYPE CONST. V_ 411 GRP. B --v
Address -206 STE BTRBBT
A.P. Number
City Zip Tel.
DES P'OINES I). 50309 515-243-2131 Legal Description
Contractor Project Description TENANT IY++IPROVEt NT PARTITION W)
D&D IJJTEI P CONST. r INC. SMALLS, T -•BAR CEILING, LIGHTS p AND
Address
s
2914 XAT-ELLA- • AVR # RECEPTACLES.
City --
Zip Tela
(MARGE.. %A. - 92667 714-619-0411`1y
State Lic. i City
& Classif. Lic. # Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer ' ' New ❑ Add ❑ Alter H Repair ❑ Demolition ❑.
Address Tel.
City ,zi p'y State
Lic. #
rICENSED CONTRACTOR'S DECLARATION
ghereby affirm that I arif licensed underlprovisions of;Chapter 9 (commencing with Section
70of`Divisiof theBusiness�!fa'nd Professions Code,.a 'd my license
is int� full
for�and
effret"r114, IV f% 1. V!{
_SIGNATURE) DATE
OWNER -BUILDER DECLARATION Estimated Valuation
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, after, improve, demolish, or repair any structure, 'prior to its issuance also
requires the applicant for such permit to fife a signed statement that he is licensed pursuant to PERMIT AMOUNT '•
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 civil penalty of not more than five hundred dollars ($500).-
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, andthe structure is not intended or offered for. sale. (Sec. 7044, Buisness and Const.d •
Professions Code: The 'Contractor's License Law does not apply . to an owner of property who
builds or improves thereon and who does such work himself or through his own employees, Mech.
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical �� • -
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
Strutt the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for .$, M.I. - JL • S
such projects with a contractor(s) licensed pursuant to the Contractor's LicenseLaw.)
- t, Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
r WORKERS' COMPENSATION DECLARATION
I hereby affirm that I, have a certificate of consent to self -insure, or a certificate of
Worker's Com ensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.� Company 6't�ik�t3
❑ Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL 1 •
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or fess.)
I certify that in the performance of thg 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: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum $etbackaD:istances ..
comply with such provisions or this permit shall be deemed revoked. s, -
• Frorit-Setback from Center Line '
$ Rear Setback from Rear Prop. in, y
CONSTRUCTION LENDING AGENCY Sid treet S Ck fro ent L ne
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.) Sid lMtba rOp y in 4
Lender's Name
Lender's Address {
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE—
This
expiration if work thereunder is suspended for 180 days. V eJ
�- - - y., J
I certify that I have read this application and state that the above information is correct. Issued by: "'Date_! P I "L
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. By—
Signaturet
mentioned property for inspection purposes. Validated by:
of applicant_ Date r�
Mailing Address Validation: i
City, State, Zip 4
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
y
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO 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
LAUNDRY TRAY
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.
SO. FT. ® c
BATH TUB
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Va c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
ERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE [PIL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE FPLUMBFEE
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$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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CITY OF LA OUINTA
a DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
C11Y Us :�►" UR NOTICE FOUR INSPECTIONS
AP � � 1993
Owner
F>. Q T—� iANG- X41,
Controo D&D INTERLOOP CONST.,INC.
2237
Permit Number
POST ON JOB IN CONSPICUOUS PLACE
' INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-590 HIGHWAY 111
TENANT IMPROVEMENT
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
!,r C '
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC _ F
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT- A/C
FIREPLACE
ROOF
BOND BEAM
O.K.,TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING , -
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR - -
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE &GATE
SEWER SEPTIC TANK
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4!88