04823 (BLCK)P.O. BOX 1504
Building.'78-105 78-105CALLEESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner -,
t,Starr 6ustruction
"
Mailing
BUILDING:`TYPE CONST. OCC. GRP.
Address 47 S. Tahouits Way 02A._P..Number_
773-044-020-& 021
City,
Zip
Tel.
��'inc
��St
92262
322 -*102
Legal Description
Project Description
-2301 yof 6' ciarde i wall
Contractor
Address
J
City-
Zip
Tel.
State Lic.
& Classif. 387934
City
Lic. # 895
Sq. Ft., , , , , ,
Size
,'- No..
Stories Units.
Arch.,.Engr.,
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Designer
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby m affirm that I alicensed 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- ,,!r YJ
'
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,Susiness and Professions Code: Any city or county which requires a
Permit to construct, atter, 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
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 bask
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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
• Professions Code: sThe 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,
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
of proving that he did not build or improve for the purpose of sale.)
Estimated Valuation
,i ,
,>'
PERMIT
'
_ AMOUNT
Plan Chk. Dep.
-
Plan Chk. Bal.
-
Const.
�t
Mech.
Electrical -
Plumbing
'
O 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 tothe Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
S.M.I.
**U
Grading
'
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consentrto self:insuie, or a certificate of
Worker's Compensation Insurance, or a certified copy _thgreof(5ed' 3800, Labor Code.)
Policy No. Company Ler ,;C;... (,?
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
r
TOTAL
�•," ,� ,
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuatkm`J'.%'�^
or less.)
REMARKS
wx `
¢Y �''�` v f a 'd b ►, "'` t<L+�% +�
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 California.
7;� Ert`4*Y'.i I i;> Y §`!'i., M
Date Owner '
NOTICE TO APPLICANT: If„ alter making this Certificate of ' Exemptionyou should become
subject - to the' Workers' . Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. -
ZONE: BY:
-
Minimum Setback Distances: ,.
Front Setback'from Center Line
_
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCYSide
1 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.) ,,
Lender's, Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to °-'
expiration
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.ISSUed
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. -
Signature of applicant Date •
FINAL DATE
-
by:
Validated by -
Street Setback from Center Line
- Side Setback from Property Line `�•
RF
INSPECT1/15OR438.!,'-- -
OR-
Date Permit
MailingAddress
Validation:
-
City, State, Zip '
-
GOLDENROD ASSESSORS OFFICE HARD COPY -FILEsz
'+x -..-.• 1. r. _..,-r..-...- ..-..- ..t. -a ,.�..w.r..0... a.. _.i-,..� .
WHITE FINANCE PINK APPLICANT GREEN BUILDING,
�,.� ,Y.,r _� A�.';.K,-, .� a�'L X..,_+i ._, r.. �.••, •,'. +,,:.�.y�Y:. _:k ` �1.. +�•s.. T. �...e} �1..e..'.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT y S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. C
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
GAR SO. FT. ro
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO FT. ra
GROUT
WATER HEATER
WALL SO. FT. g
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. ra
-S
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISHI
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID g 1'A c
SEWAGE DISPOSAL
SO.FT.GAR G3' ;4c
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 ELECTRICAL HEATING 8 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 APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—X$
-S
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
' INSULATION/SOUND
FINISH GRADING
?gFI!AL INSPECTION
a�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL