04919 (SFD)P.O. BOX 1504 No. 04919
Building78-105 CALLE ESTADO
49-040
Address Quimara Court LA OUINTA, CALIFORNIA 92253
Bar ConDevelopment
Mailing
Address 68-713 Perez Rad4
City Zip Tel.
Cathedral City 92234 1 773-9024
Contractor
BUILDING: TYPE CONST. OCC: GRP..
A.P. Number Parc Lis Quistta
Description
Project Description Platt 2017, Lot 32
Address
City Zip Tela
State Lic. City
& Classif. . 773077 Lic. # 1213 Sq. Ft. 2017 No. 2 No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my_license•isvn full force and
effect.! - mr a% J I
_SIGNATURE DATE
OWNER -BUILDER DECLARATION'
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a
Permit to construct, after, improve, demolsh, or repair any structure, prior to its issuance also
requires the applicant for such permd to Ide a signed statement that he is licensed pursuant to
the provisions of the Contractors license. Law, Chapter 9 (commencing with Section 7000) or
awsion 3 of the Business and Professions Cade, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penally of not more than five hundred dollars (8500).
❑ 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 Cordmctoes 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 inprovememts are not intended or offered for sale. If, however, the building
or improvement is said within one year or completion, the owner -builder will have the burden
of proving that he did not build or improve forthe purpose of sale.)
❑ 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 inproves 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
1 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
O 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 ($100) 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.
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 inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS A�fXXf pQ�
.. , dt'7 : GlKtc.4 �' c. 's: ,+R�4wt•..,".1—U44y'g,.rr.."
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 119 IN2S�PEC-ThR
Issued by: Date f Permit
Validated by:
Validation:
Estimated Valuation $1020%6
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
368.65
Const.
0.50
Mech.
42.00
Electrical
79 ..,50
Plumbing
94.00
S.M.I.
7. 1.8
Grading
Driveway Enc.
Infrastructure
2,295.59
TOTAL $3s327..62.
REMARKS A�fXXf pQ�
.. , dt'7 : GlKtc.4 �' c. 's: ,+R�4wt•..,".1—U44y'g,.rr.."
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 119 IN2S�PEC-ThR
Issued by: Date f Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL SO. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. I SO. FT.
WALL SO. FT.
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
STORAGE TANK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
ROCKSTORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
OTHER APPJEQUIP.
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.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
FINAL INSP. Q 1 g(,Kjcu.
SO.FT.GAR ® 3Yic
HOUSE SEWER
ROOFING lC'l % �%r
v�
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
ETB �`�S
ND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. Q 1 g(,Kjcu.
FRAMING (� 'jam G
FINAL INSP.
ROOFING lC'l % �%r
v�
( n
F� t'�L V
v/fes
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL