002246 (SATT)Building 80":5U Pile BiWwch'
Address
Mailing
Address 75-005 E
City
Part Deseft
Contractor.
Nat'. ma
• Address
CitySam
.. _
Zip
92260
tame and
Zip
P.O. BOX 1504 NO, 002245
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST: OCC: GRP.,
A.P. Number.
Legal Description
Project Description FM " 3 WIN 10
Phase 19 B -
Tel'. ;
State Lic.
City
nit
& Classif.
•
Lic. # 328
Sq. Ft. gLrt582No: No. Dw. Z
Size Stories Units
Arch:;. Engr
Designer-
'New Add ❑ Alter ❑: Repair ❑ Demolition ❑ -
Address
Tel.
r
City
Zip
State
.Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that Lam licensed under provisions of Chapter 9 (commencing with Section
7000) of'Division 3.of.the Businessland Professions Code, and my license=is,in fulhforce and
effect. ! f ,r
_
, . ..... - .. .. .. _
1, t .' DATE
• SIGNATURE' U- ,I:ini A':k'i, ° r.4"
• �� ` • +(/ WNER•BUlt DER DECLARATION
y p , g
I hereby affirm that I am exempt from the Contractor's License Law for the. followin
• 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 applicantfor such permit,io File a signedstatement 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 or Section 7031.5 .by 'any. applicant for, a permit
- subjects the applicant'to'a'civil'penalty of not more than five hundred dollars (S500):
0,1, as owner of the, property, or my employees, with wages as their sole compensation, will
Estimated Valuation -144,52.7.00
-
- -
- PERMIT` AMOUNT
,
Plan, -Chk. Dep..
. .
Plan ChkBal�;,�.� �.� .
Aq
COnSt . tl . 50
-
do the work, and the structure is not intended or offered for•sale. (Seca 7044, auisness 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
o f proving that he did not build or improve for the purpose of sale.) - -
Mech - - S� '
Electrical - - 3.02.17.
..Plumbing 128 w 5 0
-
O 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
�1
S.M.1. - - - 99*84
Grading
Driveway Enc.
Date owner
Infrastructure 2,000-000
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
.❑ Copy is filed with the city. , ❑ Certified copy is hereby.furnished..
TOTAL 3,303.90
REMARKS
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 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.
- 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
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 Address
FINAL DATE INSPECTOR
.
F
Issued by: Date d Permit
Validated by:
.Validation:
A5093 4 8 33t 3,90 LK
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.
agree to comply*with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives.4of this city to enter the above-
mentioned property for inspection purposes. ,' ` ' ' .• � s^ 11
fn
Signature of applicant � ., ` ,/�_-f"r % "Si:A% t_ Date 7 ;'jcy, y
Mailing Address % % '' •jj ��" .7 `
City, Slate, Zip
1 HARD COPY
CONSTRUCTION ESTIMATEftilii
NO. ELECTRICAL EEUjk EE'
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
2ND FL. SQ. 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 APPJEQUIP.
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.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
O ��r �O`�LC �GN1 t
SQ.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
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
0 SETBACK G, /D L
GKGROUND PLUMBIN '
UNDERGROUND
A.C. UNIT
COLL. AREA
o -SLAB GRADE O
(,ROUGH PLUMB. O
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SEPgC jq4
/ .ROUGH WIRING ) O
/
DUCT WORK
ROCK STORAGE
ra FOUND. REINF. �
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICErye�
INAL INSP.I�f,I� I/�
Y/
BOND BEAM
WATER SYSTEM
GRADING
CU. yd.
$ Plus -X$-=$
LUMBER GR.
A4 INAL INSP. OZ
,!/FRAMING /
FINAL INSP.//1 /rl' G /
C
/ //�
%(/ROOFING ri�GIL
O ��r �O`�LC �GN1 t
�CIQ/L /t;J _�1 �� (
d
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
7�4/INSULATION/SOUND/ "/' /
``
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I N brCG 1 Un "A WUng1 VnrWIN11 IALS,
GARDEN WALL FINAL