002478 (SATT)Building 55-- O �. .
Address
Owner
Address
City
Contractor
ress
Zip
To c
P.O. BOX 1504 No. 002478
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: -TYPE CONST. OCC: GRP. '
A.P. Number
$ Legal Description
Project Description P.G.A. TM - P
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City.... ]ZIP
Sam
., ..Tel...
.
State Lic.
& Classif.. 13
-En
City
Lic: # 328
LM 3478
Sq. Ft. No. No. Dw.
Size 696 Stories Units
Arch. gr.,
Designer
New ❑X Add'❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
State
JZip
Lic. #
1
LICENSED CONTRACTOR'S DECLARATION
I hereby -affirm that I em licensed under, provisions 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.
i
SIGNATURE ' • DATE
' OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
211'438o00
reason:. (Sec. 7031.5, Business and Professions Code: Any city or county which requires a'
- PERMIT
'
AMOUNT
permit to construct, alter, improve, demolish, or repair any, structure, prior to its issuance also
requires the applicant for such permit to rile 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 eriempt 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
Plan Chk. De p
,,r{�� eri�
25y, -00
Plan Chk. Bal.
- ' ' 343.98
Const.
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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
Mech.
.00
builds or improves thereon and who does such work himself or through his own employee's,
provfded 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
or proving that he did not build or improve for the purpose of sale.) . - '
Electrical
y
140. �3
Plumbing -
�} t`
- 3.44.513
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
slruct 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.
S. M. 1.
- 31
such projects with a contractor(s) licensed pursuant to the Contractor's License -Law.)
.❑ I am exempt under. Sec. B: & P.C. for this reason
Grading
Driveway Enc.
Date Owner
Infrastructure
LOO.vi#'
WORKERS' COMPENSATION DECLARATION
' Ihereby affirm that I have •a'certificate of consent to.self-insure, or a certificate-bf,
-
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. -O Certified copy is hereby. furnished.
TOTAL
3*665..€ 2
REMARKS
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 lhp 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. It, after making this Certificate of Exemption you should become
'ZONE:
BY:
subject to the'Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this 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
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.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
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.
Issued by:
p
—23— '
Date Permit
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. _
-
Validated by:
Signature of applicant f `+ Date
Mailing Address s
Validation:
A6107
% 31 541562 CK
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
IST FL. SQ. FT. ®
2ND FL. " SO. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
NO. ELECTRICALS
UNITS
MOBILEHOME SVC.
POWER OUTLET
NO. PLUMBING FEES
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRY TRAY
AIR HANDLING UNIT CFM
OTHER APP./EQUIP.
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
GRADING
cu. yd.
$ plus x$
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
FINAL INSP.
SQ.FT.GAR p 3/ac
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 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
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS-
GARDEN WALL FINAL