06448 (SFD)C&t!t 4
P.O. BOX 1504 No. 06448
Building 78-105 CALLE ESTADO
Address 44-400 B1ttt4ivig Star Trait LA QUINTA, CALIFORNIA 92253
Owner
Mailing
A Ns n A Asa iAten BUILDING: TYPE CONST. OCC. GRP.
Address 43-875 Nasbington St. A.P. Number Tract 22982 P%ase III
City Zip Tel.
Palter Desert 92200 345-7541 Legal Description
COOtractor Project Description Plan 5158 Lot 7&
E. G. WilliIu s Dev. Corz>'.
Address
City Zip Tela
State Lic. City
& Classif. 493919 Lic. # 1131 Sq. Ft. 2134 No. No. Dw.
Ardx, Engr, Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby ailmm that I am licensed under provisions of Chapter 9 (commencing with Section
=I*
3 of the Business and Professions Code, and my license is in full force and
SKMATUM DATE
Ot1NER•BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following $113.413
reason: tsar. 7031-5.ausihess and Professions Code: Any city or county which requires a
porta- b eoratr'ucl. airer, irprove, demolish, or repair any structure, prior to its issuance also
replies so appicaw tar such permit to hoe a signed statement that he is licensed pursuant to PERMIT", = ,N AMOUNT
me prwi - of the Contractor's license Law. Chapter 9 (commencing with Section 7000) of �..
Rl®n 3 of the Bines and Professions Code• or that. he is exempt therefrom, and the basis
kv she alleged exenption. Any violation of Section 7031.5 by any Vpficant for a permit Plan Chk. Dep.
sutherraripe dvopenakyofnot more than rive hundred dollars ($5o0). Bal. O L as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. fi 570,32
do the work. and the structure is not intended or offered for sale. (Sec. 7044, Buisness and ten en
Pral(`,O
essions Cade., The Contractor's License Law does not apply to an owner of property who Const. "8.50
bill or improves Hereon and who does such work himself or through his own employees, Mech.
phot. Bat such such irprovements are not intended or offered for sale. If, however, the building
or 53.50
improvement is sold within one year of completion, He owner -builder will have the burden Electrical (�
a/provig fiat he oldra
not build or irprove for the purpose of sale.)
El %as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing8 n
st uct the project- fSec- 7044, Business and Professions Code: The Contractor's Ucense Law 4�
dbes not apply to an owner of property who 1xiOds or improves thereon, and who contracts for S.M.I.
subprojects with a contractor(s) ice nsedpursuant to the Contractor's License Law.)
111 an ererrpt under Sec- B. & P.C. for this reason Grading
Driveway Enc.
Isle per Infrastructure 2.551.79
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
workers Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy Ito Company
O Copy is filo with the city. O Certified copy is hereby furnished. -
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS? COMPENSATION INSURANCE
!this svxtiI need not be completed ff the pemrt is for one hundred dollars ($100) valuation ], t 1 (,ri..i.) 1 ttn t . ►
ores)
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
M0710E TD APPL1COWT. s, after making His Certirrcate of Exemption you should become ZONE: BY:
subject to the %brims' Compensation Provisions of the Labor Code, you must forthwith
comvy udh such Provsians or His Permit shall be deemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
1 hereby affirm that there is a construction lending agency for the performance of the
work forwhian this permit is issued. (Sec. 3097. CM Code.) Side Setback from Property Line
Landers Name
Lewarxs Address FINAL DATE INSPECTOR
This is a buikling permit when properly filled out, signed and validated, and is subject to /
expiration it work thereunder is suspended for 180 days. 104/89
1 certify that I have read this application and state that the above information is correct. Issued by: Date Permit
1 ogee to campy 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.
bove-
m ntionedpropertyforinspectionpurposes. Validated by:
Signahme of applicant Date
Ma�rng Address Validation:
City. State; zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
DUCT WORK
ROCK STORAGE
FOUND. REINF, J`J )Z `
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT, ®
REINF. STEEL
GAS (FINAL)�� TEMP. POLE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER 00, SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SQ. FT.
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
WALL SQ. FT.
LUMBER GR. FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
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.
SQ. FT. RESID ® 1 % c
SEWAGE DISPOSAL
SQ.FT.GAR r@ 3Yac
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 & AIR COND. SOLAR
SETBACK
GROUND PLLrMfBlNfG �' , UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 10 C{�
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF, J`J )Z `
GAS (ROUGH) Z/7 9v METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)�� TEMP. POLE
GROUT
WATER HEATER 00, SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR. FINAL INSP.
FRAMING E �j gl/� FINAL INSP.
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL //yy
LATHING /1 L✓ ( % Y��
MESH
.L
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
=Mrc Muei
REMARKS:
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL