002219 (SATT)4
P.O. BOX 1504
Building. 78-105 CALLE ESTADO
a
Address 4""531 Febble Beadh LA QUINTA, CALIFORNIA 92253
Owner
maning
Address 75-005 M=Y Club Dr.
City Zip Tel. 568-2828
92-760
Contractor
Address
City IZip Tel.
No. 002219
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description r m9m. PIM .10
PhaW5B
State
State Lic. City MZ 2272.
& Classif. 288134 Lic. # 328 Sq. Ft. IM 582 No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer New ❑x Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
. ... Lic. # _
_ LICENSED, CONTRACTOR'S DECLARATION
herebyy.affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division•3 of the Business,and Professions Code, and my license is in fulll.force and
effect. q �.:, ,+ ,
SIGNATURE r' : / l'e re" C+ DATE
/ i -'01NNER-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 toffile 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. (Sec. 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 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
Estimated Valuation
144,517
-PERMIT
Plan Chk. Dep. .
Plan •Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent. to self -insure, or acertificate 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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it 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 ofExemption 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.,
s
Signature of applicant A, Date � $
Mailing Address 1 t
City, State, Zip f !.
HARD COPY
TOTAL
REMARKS
AMOUNT
462.89
545.54
55.00
102..17 . .
1.28.50
9.84
2,000.00
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 4-7-06 Permit
Validated by:
Validation:
A508 i
4 8 331,3,90 CK
CONSTRUCTION ESTIMATE i
NO. ELECTRICAL F&III01,
NO. PLUMBING FEES
IST FL. SO. FT. ® $.
UNITS
/SETBACK
OLALAB GRADEOUGH
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. 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
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
op "" �—��LF.I
R.i.NAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM.
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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
jL6LATHING 0 `d -J t7
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
rOROUND PLUMBING q
UNDERGROUND
A.C. UNIT
COLL. AREA
/SETBACK
OLALAB GRADEOUGH
PLUMB. S is.'
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
C EWER OR SEPTIC TA/'If
OUGH WIRING 4
0
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
T( REINF. STEEL L( / �%
/
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
op "" �—��LF.I
R.i.NAL INSP.
RAMING �{
jNAL INSP. ����a
ROOFING ate/
1�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
jL6LATHING 0 `d -J t7
MESH
)vJ(—INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL