06446 (SFD)T4hf 4 4 Q"
Building
Address 44-370 Buttercup Lame
Owner
La OuintthB8OCUte8
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Address AI -M L7 f
City Zip Tel.
ftlu Desert 1 92264 1 345-7541
Contractor
E. C. Nillimis ilei. Corp.
Address
City lZip
State Lic. 693919 ( City 1231
& Classif. Lic. #
Arch, Engr., I
Designer
Address I Tel.
City IZip I State I
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 affirm that I am licensed under provisions of Chapter 9 (commencing with Section
700q . t)ivision 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNEWBUILDER DECLARATION
I hereby affign that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiness and protessions Code: Any city or county which requires a
premum- So construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the Wpicant for such Dem* to fie a signed statement that he is licensed pursuant to
She prorsiorts of the Conbactors License taw, Chapter 9 (commencing with Section 7000) of
Dk*; oo 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
dor the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
stlmjecfs the appicamt to a civil penalty of not more than five hundred dollars ($500).
® 1, 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
ba1S or improves thereon and who dues such work himself or through his own employees,
p nKW that such irprovements are not intended or offered for sate. If, however, the building
or irprovanent is said within one year of completion, the owner -builder will have the burden
of Proving that he did not Wald or improve for the purpose of sale.)
® k as owner of the property, am exclusively contracting with licensed contractors to con-
slnlct the projecL (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_ a, & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Wakens 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 fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
section need not be completed ff the pemrl is for one hundred dollars ($100) valuation
1 certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Lars of California
Date Owner
NOTICE TO APPI1CANT: ff, after making this Certificate of Exemption you should become
subject fo the Workers' Compensation provisions of the Labor Code, you must forthwi0r
comply wilh such provisions or On Peron shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders Address
This is abuilding permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes
Signabire of applicant Date
Mailing Addmss
C ty. State. Tip
No.
11LDING: TYPE CONST. OCC. GRP._
P. Number Tract 22982 P'i wm III
Legal Description
Project Description plait 2$R Lot 68
06446
Sq. Ft. > No. No. Dw.
Size 1621 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
PERMIT,.
AMOUNT
Plan ChkNDep.
Plan Chk. Bal.
8.77
Const.
585.50
Mech.
53.50
Electrical
104#00
Plumbing
123.0
S. M.I.
6.15
Grading
Driveway Enc.
Infrastructure
1,969.07
TOTAL
$3,330.30 'r) -t ;<C_JC_1
REMARKS
r,e ._nyn qis♦ r�y'i1a iA—X6._(]O ttj
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 Prope(ty Line
FINAL DATE INSPECTOR
10/3/83
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
j L67
YARD SPKLR SYSTEM
2ND FL SD. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. I SO. FT. ®
WALL SO. FT.
DRINKING FOUNTAIN
SERVICE
FINAL INSP.
URINAL
SO FT ®
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
LAUNDRYTRAY
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEEMECH.FEE
PL.CK.FEE
CONST. FEE JELECT.FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBINGELECTRICAL HEATING & AIR COND. SOLAR
"q Olt
SETBACK
GROUND PLUMB
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
j L67
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) �' �/
G
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
LUMBER GR.
FRAMING
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
!i /'
LATHING,2[4_
MESH EEF EEE K
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL
WATER SYSTEM
FINAL INSP.3
FINAL INSP.
0
GRADING
cu. yd.
$ plus x$
REMARKS: