003020 (SATT)Building
Ad�r�s� SE
Mailing
Address 75-005 Gou
City
..PA-k1m
Contractor
Address
Sime
State Lic.
& Classif. 288130
Arch., Engr., -
Designer
Address
T4hf 4 4 . a"-
ntry Club Drive
Zip Tel.
92.260
Drteaae =d Lan
Zip
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 003020
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description PGA West Pbase 4B
d
Plan 2+x:
I Lic. # 32S
Tel.
Sq. Ft. DW '6596 No.
Size r- Stories
New M, Add ❑ Alter ❑. Repair ❑ Demolition ❑
No. Dw.
Units
City
Zip
State
Lic..# _
LICENSED CONTRACTOR'S DECLARATION "
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with -Section
'*000) of Division•3 of the Business and.Professions Code, and my license is in ffuull`forcee,and�%
effect.-
ffect. " . %/ f:r•'P:'
t
SIGN_ A_TUR_E < a` DATE
SIGNATURE
OWNER -BUILDER DECLARATION
Estimated Valuation
1. hereby affirm that I am exempt from the Contractor's License Law for the following
s�gn �sy
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reason: (Sec. 7031.5,Business and Professions Code: Any city- or, county which requires a
76818.
Permit to construct, alter, improve, demolish, or repair any .structure,. prior'to its issuance also
'requires the applicant for such permit to file a signed- statement that he is licensed pursuant to
PERMIT - AMOUNT
the provisions or the Contractor's License Law, Chapter 9 (commencing with Section .7000) of
' Division 3 of the Business and Professions Code, df:thae he is exempt therefrom,and the basis-
for the Any Section 7031.5 by 'any for
Plan Chk.. Dep..
alleged exemption.. violation of applicant a .permit.
" subjects the applicant to a civil penalty of not more than five hundred'dollars ($500).
q R
Plan Chk. Bal..
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
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do the work, and the structure Is not intended or offered for sale: (Sec. 7044, Buisness and
Const. fj3
Professions Code: The Contractor's License Law does not. apply to an owner of property who
R�� ,
builds or improvesreon and who does such work himself or through his own employees,
Q
Mech. - ' 55.00
provided that' such improvements are not intended or offered for sale. If, :however, the building
•f ¢YF/
or improvement is sold within one year of completion, the owner -builder will have theburdenElect
Electrical - ��"�
of proving that he did.not build or improve for the purpose ofsale.)
❑ I, as owner of the property, am exclusively contracting, with licensed contractors to con-
-Plumbing 132.54
struct the project. {Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply town owner of property who builds or improves thereon, and who contracts for
- gg p
S.M.I.' _ 12.57
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0 1 am exempt under Sec. • B. 8 P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure 2000.00
WORKERS' COMPENSATION DECLARATION
I hereby affirm that,Wl ave a certificate of consenf 'to self -insure, or'a.cert cafe
Worker's Compensation Insurance, ora thereof. -3800, -Labor Code.)'
certified copy (Sec.
Policy No.— Company
0 Copy is,filed with the city. D Certified copy is hereby furnished. "
✓j
TOTAL $3471.23
_
CERTIFICATE OF EXEMPTION FROM
REMARKS
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
ZONE: BY:
' "subject to the Workers' Compensation provisions of the Labor Code, you must 1forthwith
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
1 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:
g
4-2-87
G C3!
I certify that I have read this application and state that the above information is correct.
Issued by: Date Permit _
Lagree 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 Date
Mailing Address
Validation:
City, State, Zip
E)658. 4 - 3
=4 %1,23 fl
- HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL.SO. FT.
POR. SQ. FT. ®
GAR: SQ. FT. ®
CARP. SQ. FT.
WALL SQ. 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
OUGH PLUMB. __?- S
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR. SUSPENDED
( AS (ROUGH) ¢. S�
V c
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
/�,1'FRAMING ;L-/OAiPf
INSP�0
GAS PIPING
PERMIT FEE
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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
O SETBACK G/��O - {�
,ROUND PLUMBI!- Sr- P1
UNDERGROUND
A.C. UNIT
COLL. AREA
!4,eSLABGRADE 5^-.2-1 �
OUGH PLUMB. __?- S
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
(`EWER OR SE5rC,VA)4-(-�
-2-
e,&UGH WIRING 5-2-F-)
DUCT WORK
ROCK STORAGE
FOUND. REINF.
( AS (ROUGH) ¢. S�
V c
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
9U,-REINF. STEEL L -
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$ _ $
LUMBER GR.
l�fINAL INSP./U- 9 _.
/�,1'FRAMING ;L-/OAiPf
INSP�0
c ^INAL
OOFINC� _Y!` �O- d /
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hk GC A,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
Q.,dATHING
MESH
INSULATIONISOUND
5�/ ��[[
FINISH GRADING
?W6FINAL INSPECTION /
JJ��GG
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL