05160 (SFD)Tiqt 77
P.O. BOX 1504 No. 05160
Building 78-105 CALLE ESTADO
Address 44-240 Calico Circle LA QUINTA, CALIFORNIA 92253
Owner
La Quince Associates
Mailing I
Address d3—R75 Wa Rhington St.
City lZip ITel.
Contractor
ress
Tel.
State Lic. City
& Classif. 493919' Lic. #
Arch., Engr.,
Designer
Address
el.
City IZIP( State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70111)) of Division 3 of the Business and Professions Code, and my license is in full force and
effect �• _ , i � 7
SIGNATURE - - DATE
OWNER•BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busbess and Professions Code: Any city or county which requires a
permit to construct, after, improve, demoish, or repair any structure, prior to its issuance also
requires the applicant for such permit to fie a signed statement that he is licensed pursuant to
the provisions of the Contractors 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 civilpenally of rot more than live 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 Contractors 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.)
O 1, 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) icensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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
0 Copy is filed with the city- ❑ Certified copy is hereby fumished.
l/ CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This sectbn need not be co piated it the penidt is for one hundred dollars (5100) 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 or the Labor Code, you must forthwith
comply with such provisions or Osis permit shag be deemed revoked.
CONSTRUCTION LENDING AGENCY
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 property 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 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
bovementioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
LDING: -TYPE CONST. OCC: GRP..
P. Number cactilig 1?1011r•_r
[Legal Description
Project Description
VI AT, hAR a T.fvf-
11? _-
Sq. Ft. 2887
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$881500
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
& 356.68
Const.
430.00
Mech:3
0
36.00
Electrical
7R.A9
Plumbing
82.00
S.M.I. ,
A. 9n
Grading
Driveway Enc.
Infrastructure
2.221.98
TOTAL
.13.212.45
REMARKS
t3: -i0 Z81C1 -t(,f-
RV i�lYutf .L t"Y: 1m�K• t JrYi.a i.r
ZONE: BY: f
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
12/29/88
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SO. FT. @
DUCT WORK
ROCK STORAGE
OU EINF.Z
[
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
REINF. STEEL
GAS (FINAL) Gi TEMP. POLE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SO. FT.
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
WALL SQ. FT.
LUMBER GFL
DRINKING FOUNTAIN.
SO FT ®
FINAL INSP.
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FINAL INSPECTION
SQ.FT.GAR ® 3/ec
HOUSE SEWER
CERT. OCC. -
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 GOND. SOLAR
CKz +
ND PLUMBINGZ Zi UNDERGROUND
A.C. UNIT
COLL. AREA
DE 2—(5
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FO MS
SEWER OR SFKfICtfT ROUGH WIRING.
DUCT WORK
ROCK STORAGE
OU EINF.Z
[
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPIEOUIP.
REINF. STEEL
GAS (FINAL) Gi TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GFL
FINAL INSP. 6/ � /
I
F MING L(J�
FINAL INSP.
FING 3-�o
/ - , [ 4
O•� � wl�(i�
REMARKS:
VENTILATION t
RRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING d'# W Lt
MESH
INSULATIOWSOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC. -
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL