06588 (SFD)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 44"065 Carmen Place LA QUINTA, CALIFORNIA 92253
Address 74-923 Hoi
City lZip
Palm. Desert 92260
Contractor
Same
Address -
City
Zip
rt Dev.
130
Tel.
340-9174
State Lic-
& Classif- 505699
City 1383
LicAt
Arch., Engr.,
Designer
Address
Tel.
City
Zip
State
$ 489.07
Const.
Lic. #
No. 06588
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number La Qt,3ata Siabiands YT 23269
Legal Description
Project Description Platt C, "Lot 16
-Sq. Ft. 1583 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
jLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I,am licensed under provisions of Chaptei 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is inn full force an�d�
effect /r f J i t t:/ 7 i illi r
SIGNATURE
-r DATE
- DATE
OWNEIFBUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason: (Sec- 7031-5,Busbess and Professions Code: Any city or county which requires a
Penn# to construct, alter. Jrnprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Ile a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Divisor 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
sutfacts the applicant to a civil penalty of not more Oren five hundred dollars ($500)-
0 1, 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 Cordractoes License Law does not apply to an owner of property who
bdkls 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. ff, however, the building
or improvement is sold within ane year or conpletiwn, the owner -#rider 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 no apply to an owner of property who buds or improves thereon, and who contracts for
such projects with a contractor(s) icersed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof- (Sec- 3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city- ❑ Certified copy is hereby fumished-
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed O the pend is _for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the 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 8, after making Oris Certificate of Exemption you should become
subject to the Workers' Compensation provisions of One Labor Code,, you must forthwith
carpty with such provisions or this permit shag be deemed revoked
CONSTRUCTIONLENDING 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-)
Lenders Name
Lenders Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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-
Signature
urposesSignature of applicant Date
Mailing Address
City, State, Zip
REMARKS . - - I — -.- f
0" ,
r�t1t IV t r0bli_ ; , X1.',3 '-I . )
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 DATEINSPECTOR
10,125189
Issued by: Date Permit
Validated by:
Validation:
Estimated Valuation
i3 4
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 489.07
Const.
585.50
Mech.
60.00
Electrical
101.21
Plumbing
120.50
S.M.I.
6,.16
Grading
Driveway Enc.
Infrastructure
11970.80
l
TOTAL 1 $3.333.24
1 J Y
REMARKS . - - I — -.- f
0" ,
r�t1t IV t r0bli_ ; , X1.',3 '-I . )
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 DATEINSPECTOR
10,125189
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE (gy
ROUGH PLUMB.
F�SE��QREPTIC
804 DING
YARD SPKLR SYSTEM
2ND FL. S0. FT.
FORMS
TANK
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. @
POWER OUTLET
ROOF DRAINS
HEATING (F INAL)
OTHER APPJEQUIP.
DRAINAGE PIPING
CAR P. I SO. FT.
TEMP. POLE
WALL SO. FT.
GROUT
DRINKING FOUNTAIN.
SQ FT ®
FINAL INSF.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_$
FLOOR DRAIN
MECHANICAL FEES
FRAMING r FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1'A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
FEE PL.CK.FEE
CONST. FEE ELECT. FEE
144A
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELEC ICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING Q!/
UN D RGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE (gy
ROUGH PLUMB.
F�SE��QREPTIC
804 DING
HEATING (ROUGH)
STORAGE TANK
FORMS
TANK
ROUGH WIRING
DUCTWORK
ROCK STORAGE
��y
FOUND. REINF. � / may/
U
GAS (ROUGH)
METER LOOP
HEATING (F INAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)3ko fx
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSF.
BOND BEAM
WATER SYSTEM
GRADING
:u. yd.
$ pus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING r FINAL INSP.
ROOFING /y
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
=CMf'C dual
REMARKS:
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL