003164 (BLCK)P.O. BOX 1504 No. 003164
Building 78-105 CALLE ESTADO
Address Ah9*40 Vi6bi, LA QUINTA, CALIFORNIA 92253
Owner
James Uier Trus
BUILDING: TYPE CONST. - OCC: GRP..
Mailing "
Address P. G. Box 6835 A.P. Number 77�-2J2-°il07
City Zip • Tel.
Santa Rona -9U(36 .. Legal Description
Contractor3 if ; ,
- .. Project Description .. sO r'�f 3R00r41: RP-ftainins►
;33gc� E'a+�aa+k flecroi A ra€
wall
Address -. .
53-475 3ermedas '
City ' Zip Tel.'
T.ra t.'a'tilrlf-A 922514 564,4f5446
State Lic. City
& Classif. Lic. # - Sq. Ft. No. No. Dw.
- 7!C?Q^Al �A -Size Stories Units
Arch En r .. .. .. �. ... .- -
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Side Setback from Property Line
FINAL. DATE
INSPECTOR:
Issued by:
-
City
Zip
State
Validation:
Lic. #
_• -_ LICENSED CONTRACTOR'S DECLARATION.
p I hereby affirm that 1 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 .
Estimated Valuation
y��'. 00
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 rile 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 a civil penalty of nof'more than five hundred dollars ($500).
Plan Chk. Bal.
❑ 1, es owner of the property, or my employees with.wages as their sole compensation, will
'
It, or, on
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.
V �~ V
Professions Code: The Contractor's License Law does not apply to an owner of property. who
•'iSZ 'd3
- 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.) -
O 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, and who contracts for
S.M.I. •^
r
--such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
.. a
.. .0 I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' I hereby affirm that' I have' a certificate of coriserit to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
-
Policy No. - company -
O Copy'. is filed with.the city. ❑ Certified copy is hereby. turn ished. ,
TOTAL
Er t
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 less.)
I certify that in the performance of the work for which this permit is issued, I shall not
y
employ any person in any manner so as to become subject to the Workers' Compensation
'
Laws of California.
Date—LL--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
comply with such provisions or this permit shall be deemed revoked.
.Minimum Setback Distances:
Front.Setback from -Center Line
R k
CONSTRUCTION LENDING AGENCY
-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 if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the atiove information is correct.
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
Mailing Address
City, State, Zip
HARD COPY
ear Setbac from Rearr-rop. Line
Side Street Setback.from Center. Line
Side Setback from Property Line
FINAL. DATE
INSPECTOR:
Issued by:
Date • 4. /V? 14 7 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. FT. ®
GAR. SQ, FT, ®
CAR P. Q. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
��CBONDBEAM -
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 C
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR Q 3/ac
HOUSE SEWER
FRAMING
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
DUCT WORK
ROCK'STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
P`IeREINF. STEEL
^
/
111
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
��CBONDBEAM -
Gf-
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL