002224 (SATT)44
P.O. BOX 1504 N o.
Building 78-105 CALLE ESTADO
Address 8G-547 FeT� Beach LA QUINTA, CALIFORNIA 92253
Owner
81iiA1P
Mailing
BUILDING: TYPE CONST. OCC: GRP.-
- ;
Address 7 -s -ons fyX1f 7_V `„gni. Dr. A.P. Number
City lZip ITel.
Contractor
New ❑X Add ❑
Alter ❑ Repair ❑ Demolition ❑
Natl. mwtig
Address ..
City '
Zip
Zip
State
State Lic.
Lic. If
& Classif.
288130
LICENSED CONTRACTOR'S DECLARATION _..
Tel.
City
Lic. # 328
Legal Description
Project Description* PM `M-311 PIM 30 0
...Phase6B
LIM zbz-!3
Sq. Ft. (M 56f No. 1 No. Dw. a
Size Stories Units
ArcEngr.,
Designer
New ❑X Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. If
LICENSED CONTRACTOR'S DECLARATION _..
I hereby 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 full force and
effect.. : ,� l_ 1 !�
SIGNATURE %- !,'r �t "" I" :,i I "' DATE
VOWNER;BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
17$ ^307;00
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 rile 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 Ove hundred dollars'($ 500). -' '
. ❑ 1, as owner of. the property, or my employees with wages as their sole compensation, will.
PERMIT
AMOUNT
Plan Chk: Dep.
-
•
Plan Chk. Bal.
_ 529.3-0
COi1St.3��j
'
'
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,'Mech
provided that' such improvements are not intended or offered for sale. If, however, the building .
.
rj
EleCtrlcal
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 purposeof sale.)
Plumbing
❑ 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
S.M.I.
16.36
such projects -with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am.exempt under Seca B. & P.C. for this reason
Grading
Driveway Enc.
Date Owner
Infrastructure
q,fS
2a000.00
WORKERS' COMPENSATION DECLARATION
I 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.
TOTAL
3,485.17
_
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS -
(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 Califni
ora
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.
ZONE:BY:
Minimum Setback Distances:'
Front Setback from Center.Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.) . _
-
Side Setback from. Property. Line '
Lender's Name
Lender's AddressFINAL
DATE
INSPECTOR
'This is a building per 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 tis '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. , • ' r.
Signature.of applicant' .r>' ! �`f �+- %'� Date
Mailing Address •��! <� - �` r`
Issued by:
Validated by:
Validation:
A5i02
p ./yM�s
' ' . Date `6 Permit
4 8 548517 CK
City, State, Zip
_. �` HARD COPY
CONSTRUCTION ESTIMATE Adlililk
NO. ELECTRICAL EEfijo,
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SO. FT. ®
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SO. FT. ® c
BATH TUB
I NAL INSP./Dy
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/a'c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
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
ROUND PLUMBIN2 ltkQ
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE 5
ROUGH PLUMB. S
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI
'ROUGH WIRING
DUCT WORK
ROCK STORAGE
T FOUND. REINF. (�
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu.yd.
$ -Plus-X$-=$
LUMBER GR.
I NAL INSP./Dy
11/rFRAMING $ / `
�311��✓/ROOFING
l�
FAL INSP. //
7
0`
lit (LS
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
tcINSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL