002499 (SFD)Building 53-335
Address
P.O. BOX 1504
78-105 CALLE ESTADO
WS LA QUINTA, CALIFORNIA 92253
No. 002499
" Mailing
Address
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number 774--095017
Legal Description lot 6
Project Description B.F.D14
Minimum Setback Distances:
City
- Pv'�im'26Q�'"6g2
Zip
Tel.
' Contractor
Address
Side Street Setback from.Center Line
City
�B
Zip
Tel.
INSPECTOR
Issued by:
State Lic. -
& Classif. 157580
City
Lic. # 765
111 1493
Sq. Ft. CA 460 No. No. Dw.
Size Stories Units
-Arch., Engr:,
Designer•
3
New Ik Add"❑ Alter ❑. Repair ❑
._
Demolition ❑
Address
Tel.
_•
tareWnim waUs cw 1enms1rkabxkd in pmv t.
City
Zip
_
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
hereby affirm that I Am licensed underprovisions 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
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
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
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 -builder will have the burden
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-
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.)
❑ 1 am exempt under.Sec. B. & P.C. for this reason
ESiimated Valuation
Aif
- +•. ,
PERMIT
`t
AMOUNT
,
-
PI•arr Chk. Dep. 250.00
Plan Chk.. Bal.
62.26
Const.
37".00
Mech.'�'.��}
A
Electrical -
ry 6173
Plumbing - -
93.00
S.M.I.
c
5.64
Grading
32.00.,�.�
Driveway Enc.
Date Owner
Infrastructure
12(!j,(j�1
1,214.39
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
(Thissection 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
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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above 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 insect,
n purposes. I
Signature of applican Date
Mailing Address
City, State, Zip r
HARD COPY
. A.
TOTAL 1 2`70.75 1 2.530.75
REMARKS
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
Issued by:
Date 7f29 $(Permit
Validated by:
Validation:
A6065
7 29 i13o75 'lul
i
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINGINEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
LAB GRADE? 3
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
j,j`OUND. REINF.G /
as
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
WALL SO. FT.
GAS (FINAL)
DRINKING FOUNTAIN
SO. FT. ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
�b��
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
THING i
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
Qk6ETBACK d
ROUND PLUMBIN
0 5t+
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE? 3
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
�✓ FORMS
O
SE OR SE/PT C//A0:;'ROUGH
WIRING
DUCT WORK
ROCK STORAGE
j,j`OUND. REINF.G /
as
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.
FRAMINGA6 Zj /
/ l/
FINAL INSP.
I�M ��'� j%f b�
I (J O
ROOFING /N��/
�b��
p
,DEC i987
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING i
MESH
I INSULATIONISOUND J
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
I R�1�0 R�� w �• c. ol,d��� irk