003027 (SATT)Ti"it,4 4 Qum&
Building 55--616 PIme urs$
Address
s1: risco1 t7
Mailing
Address 755 Camp Club' Drive
City I Zip ITel.
Contractor
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Aaaresssme I
City . ' Zip" Tela
State Lic. I City
& Classif. Lic. # _12i
Arch., Engr:,
Designer
Address Tel.
City Zip State
• Lic. #
_ LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm -that I,am licensed.under provisions of Chapter 9 (commencing with'Sectii
7000) of Division.3`of the Business and Professions Code, and'my license'is in;ff'ull•force al
effect.
OWNER+tlU1LU"'UtGLAXA I WN
I hereby affirm that I am exempt from,the Contractor's License Law for the following
reason: (Sec. 7031,5,Business and Professions Code: Any city or county which, requires a
permit to construct, atter, improve, demolish, or repair any structure;. prior to its issuance also
requires the applicant for such permit to..file a signedstatement that he is.ficensed pursuant *to.
the provisions or the Contractor's License Law, Chapter -9 (commencing with Section 7000) or
Division 3 of the Business and Professions Code, or that. he'is. exempt theiefrorn, and the basis
for the alleged exemption. Any. violation of Section 703 1. 5 .by -any' applicant. for a permit
subjects the applicant to a civil penalty or not more than five 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 Contractor's License Law does not appy 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 safe. 1f, however, the building
or improvement is sold within one year or completion, the owner -builder will have the burden
of, proving that he did not build or improve for the purpose of sale.) -.
❑ I, 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) licensed 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 thall�have°a certificate of'consent to self -insure, orc ertificate of
Worker's Compensation Insurance, or a'certified.copy"thereof. (Sec. 3800, Labor C&fe:f
Policy No. a,Company-. -- °'Y _ -,Y-4 ..E_ / f �sl/� /
O Copy is filed with the city. . El Certified copy is hereby furnished. f ,
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 lhg 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, alter 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
HARD COPY
No. 003027
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description 3rPpsat sao_ tees
Pima 30 N
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Sq. Ft. MM .2825.
Size r_4�kR. q60.
No. No. Dw.
Stories Units
New Cl; Add ❑
Alter ❑ Repair ❑ Demolition ❑
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date 4/2/a7 Permit
Validated by:
Estimated Valuation
$394,692.00 .
PERMIT.
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.,$5g5'
10
Const.
670.50'
Mech.
55•.00
Electrical
121.71
Plumbing
136.50
S.M.I.
13.62
Grading
Driveway Enc.
Infrastructure
3.06.
TOTAL
1 031552.43
REMARKS
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
INSPECTOR
Issued by:
Date 4/2/a7 Permit
Validated by:
Validation:
A 7 6 6 5
4 3 X55243 it
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
FOR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
r
DRINKING FOUNTAIN
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
—Plus—x$—=$
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.
SQ. FT. ® c
BATH TUB
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
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
SETBACKG ,2U1
GROUND PLUME!6"—S
UNDERGROUND
A.C. UNIT
COLL. AREA
26XSLAB GRADE S —— G
ROUGH PLUMB.
(/BONDING <.I—,2o
\ROUGH
HEATING (ROUGH)
STORAGE TANK
FORMS
n
SEWER OR SEPTI6TYt_pala��
WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.G/ —
G —
C eGAS (ROUGH)C_ ,q _��
O0 /
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
n
/ REINF. STEEL l ���
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
—Plus—x$—=$
LUMBER GR.
FINAL INSP.
nn
/��FRAMING -2 -_23 —
FINAL INSP.
^�
ROOFING'IE_U< ! ` X 7
�L Q GV
✓J `C� %V V� g _ / O r
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
'<�INSULATIONISOUND '7—
,?% —��
FINISH GRADING
!YrFINAL INSPECTION/()
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL