002253 (SATT)Building80--W44
Address
s
Pebble Bawb
Owner
Address b T,`
City Zip^ _ Tel
Ratl Mir". and Lmd
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
State Lic. City
& Classif. 2NI30 Lic. # 3n
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
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. t;
SIGNATURE. V. ! DATE
fOWNER-BUILDER DECLARATION
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, 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
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 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
do the work, and the structure is not intended or offered for sale. (Seca 7044, Buisness and
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,
-provided 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 havethe 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.)
O 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 tha 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 sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant I Date I z r
Mailing Address
City, State, Zip
HARD COPY
No. 00223
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Legal Description
Project Description W: 4 tom' 'P';<'AIN hA O
Sq. Ft. ' 3142
Size GUR
No. No. Dw.
Stories - Units
New ❑g Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
0
$.197,349.00
PERMIT
AMOUNT
Plan Chk.• Dep.
Plan Chk.,Bal.
564 A9
Const.
6+78 Co
Mech.
9;9; _ 0A
Electrical
110
Plumbing
IM)
S.M.L.
Grading
Driveway Enc.
Infrastructure
TOTAL
3,„SMI _1.7
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 A—%k--Rf; Permit
Validated by:
Validation:
A.5117 4 8
�58i 1 ) LK
CONSTRUCTION ESTIMATE
NO. ELECTRICAL EESimok
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
UNITS
LAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. @
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
.WALL SQ. FT.
OTHER APP./EQUIP.
DRINKING FOUNTAIN
SQ. FT. @
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
(/,GPNAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE ' DRYER
Z_LCINAL INSP.`d t /
%
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
ITEMP 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 @ 1Ya c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
LK LATHING
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
ROUND PLUMBINSb/ d
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE
OUGH PLUMB.r 11
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
pq4EWEIR OR SEP`Y3 Tµ1�i�
oe
OUGH WIRING
DUCT WORK
ROCK STORAGE
J Q FOUND. REINF./Q
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
Ite REINF. STEEL6 g
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
(/,GPNAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
Z_LCINAL INSP.`d t /
%
FRAMING
iiFINAL INSP. /�
�
�tL/
�z ROOFING n Q�
d e
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LK LATHING
MESH
INSULATION/SOUND q o
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
irvare�, i un a awnw i vnc�im � iww
GARDEN WALL FINAL