002736 (RPL)Building
Address 55,-670 Pirteftlxst
Owner
.31=i-- CCDPWW
Mailing
Address 7cr-f)05 'gmyntry CM,
City Zip
. palm Desert0,2260
Contractor
Titv�44 . Q"
el.
G.H. 1>003. C IMSt.
..Address
68-465 Pe—m- Z
City lZip ` ' "" Te
P.O. BOX 1504
78"105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 00273
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
568-2829 Legal Description
Project Description
?'t1 fel
State Lic.
City
Minimum Setback Distances:
& Classif. 275795
Lic. # 69
Sq. Ft.
No. No. Dw.
Side Street Setback from Center Line
Size -
Stories Units - -
Arch., Engr.; -'
INSPECTOR
Issued by:
Designer
New Add ❑
Alter ❑ Repair ❑ . Demolition ❑
Address
Tel.
A 6 8 4 3
1Z 3 i$3,19 U,
City
Zip
State
Lic. #
. LICENSED CONTRACTOR'S DECLARATIOONf.',_...,'
I hereby affirm that Fam,licensed under provisions pf,Chaptl wr "(commencing with Section '
7000) Division 3 Buslness'and Professions Code;
. of of the andfm'y'license is in full force%and
effect.�r.�
•'
SIGNATURE + DATE
•. _, „
.
OWNER -BUILDER DECLARATION
Estimated Valuation
1 hereby affirm that I am exempt from the Contractor's License Law for the following
��)'
• reason: (Sec. 7031.5,Business and Professions Coder Any city or county which requires a .
I
.. permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance'also
the for to file that he is licensed to
PERMIT
-
' ' - AMOUNT -
• requires applicant such permit a signed statement pursuant
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 exempt therefrom, and the be
7037:5 'any fora
Plan Chk.. Dep.
- _
'
for the alleged, exemption. Any violation of Section Dy applicant permit
' - subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
-
Plan Chk. Bal.
��• �ti
[1 1, as ownerofthe 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
Const..�4�..
Professions Code: The Contractor's 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,
MECh•
1�
_ provided that such improvements are not intended or offered for sale. If, however;, the. building.,
.
.�q
or improvement is sold within one year of completion, the owner -builder will have the burden
Electrical
��.1JL7
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-
Plumbing
14.00
struct the project (Sec. 7044; Business and Professions Code: TheContractor's License Law
does not apply to an owner of property who builds or improves thereon, and -who contracts for
S.M.I:
.. .
1.37
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date ' Owner
Infrastructure
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
❑.Copy is filed with the city. ❑ Certified copy is hereby.furnished.
TOTAL
283.1-0
" - 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
'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 staferlaws relating to building.
construction, and hereby authorize representatives -of thislcity to enter the above-
mentioned property for inspectiomourposes.;;�—-
_ !f9
Signature of applicant '+1_. r'�• f ��• `�D e. '-S, r
Mailing Address
City, State, Zip
HARD COPY
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 12-2 36permit
Validated by:
Validation:
A 6 8 4 3
1Z 3 i$3,19 U,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT. (off
POR. SQ. FT. ®
GAR. SO. FT. ®
CARP. SQ. FT.
WALL SQ. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
I
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM _ FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL