04888 (SFD)4� 04888
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 49-100 Bala4a Coact LA QUINTA, CALIFORNIA 92253
Owner
Mailing
BaPGOY! � � BUILDING: TYPE CONST. OCC. GRP.
_
Address 8$-113 peter; Rood. 01 A.P. Number ?arra La Quiu.ta
City Zip Tel.
Cathedral City92228 - ,773-!gM24 . Legal Description
Contractor 1Project Description plea 1620, Phase I — Lot 3
Address
ate Lic.
&tClasf. 337077
Arch., Engr.,
Designer
Address
Tel.
City
Lic. #
Tel.
'—"`City Zip State
�. Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm'that I am licensed under provisions of Chapter 9 (cc
7000) of Division 3'ofrthe Business and Professions Code, and my li<
effect.
1219 . _, _ ., Sq. Ft. 1620 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
encing with Section
e is in full force and
Q / -14',&
DATE
OWNER -BUILDER DECLARATION
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 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 basis
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: 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,
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 -budder will have the burden
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,
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 to the Contractor's License Law.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (E100) valuation
or less.)
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
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.)
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. r
I certify that I have read this application and state that the above information Is correct.
1 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
Valuation $84,822
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Electrical, N z\
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
AMOUNT
325.22
388.00 s
39.00
70.20
82.00
5.92
1�9OS.�t}
Lb" err*uYr ,F cvr�`t, a svavaa:Y
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
08
Issued by: Date Permit
Validated by:
Validation:
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
iST FL SO Fl (a S
UNITS
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SO FT. S
DUCT WORK
ROCK STORAGE
OUND. REINF. —�{
(/
MOBILEHOME SVC.
BAR SINK
POR SO FT0
REINF. STEEL I
GAS (FINAL) Gr ��/ POLE
POWER OUTLET
ROOF DRAINS
GAR SO. FT. 0
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SO FT. is
LUMBER GR,
FINAL INSP. S/C�%
WALL SO. FT. Q
FINAL INSP.
DRINKING FOUNTAIN
/ --t �1
K l Lu �G�,C% �i �ZZ —�
URINAL
SO FT IB
ESTIMATED CONSTRUCTION VALUATION $
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)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
FINAL INSPECTION
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID 1 V. c
SEWAGE DISPOSAL
FENCE FINAL
SO.FT.GAR 3:c
HOUSE SEWER
INSPECTOR'S SIGNATURESIINITIALS
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.;:EE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBING/Z_i$ UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE— 0
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
F RMS
R ROUGH WIRING
DUCT WORK
ROCK STORAGE
OUND. REINF. —�{
(/
GAS (ROUGH) ( �FI ER LOOP
HEATING (FINAL)
OTHER APP./EOUIP.
REINF. STEEL I
GAS (FINAL) Gr ��/ POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
CU.Y d.
$ plus x$
- $
LUMBER GR,
FINAL INSP. S/C�%
AMING 1
FINAL INSP.
ING Z�l/ 7
cv Cv7/
/ --t �1
K l Lu �G�,C% �i �ZZ —�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GA .FIREWALL
RING
ME H
CATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL