12846 (SFD)4
P.O. BOX 1504
Building
Address 44-5555 Saffron Court LA QUINTA, CALIFORNIA 92253
Owner
5nallenberaer & Associates
Address 55-•695 Pebble Beach
City lZip ITel.
Contractor
Address
ty lZip I Tel.
State Lic. City
& Classif. B 488234 Lic. # 1858
Arch., Engr.,
Designer Carlos Elias -.Engineer
Address Tel.
38825 Charlesworth Dr. (619)328-7271
CCvathedral Citi ;p CA 92234 Lict#
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am`licensdd`Under provisions of Chapter 9 (commencin%with Section
effect. of Division !'of the Business ani - d'�rofessions Code, and my license is in full to ce"and,.
effect. �5r t7r
_SIGNATURE f ! DATE
OWNER -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. (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.)
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
Date Owner
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. O 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 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: 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
Ihereby 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 Date
Mailing Address
City, State, Zip
No.
JILDING: TYPE CONST. OCC. GRP.:
P. Number 604-252-016
12846
Description Lot 46 Tract 24208
t Description S?D Plan 2
Cactus Flower
Sq. Ft. �fi33
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$96,622.00
PERMIT
AMOUNT
Plan Chk. Dep.
• 90i
Plan Chk. Bal.
.24
Const.
62
Mech.
04*10111
Electrical
132.69
Plumbing
4.U0
.S. M.I.
• tT v
Grading
Driveway Enc.
00
Infrastructure
L •
TOTAL
•
REMARKS
11 i i ,ill
ZONE: BY:v:1
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 Permit
Validated by:
Validation:
0
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. $
- r
2ND FL. SQ. FT.
FOR. SO. FT. ®
GAR. SQ. FT. @
CAR P. SQ. FT.
WALL SQ. FT. ®
SO. 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
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
"" WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH) METER LOOP
F
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
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
FINAL INSP.
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
REMARKS:
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 T
NST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK 3
GROUND PLUMBING YAl ERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR01(%IdG
DUCT WORK
ROCK STORAGE
FOUND. REINF.2 // //
7 i
GAS (ROUGH) METER LOOP
F
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
TEMP. POLE
GAS (FINAL) :&V1
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING L
FINAL INSP.
ROOFING
O /� ���
bbb
Q!`
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE`S
SPARK ARRESTOR
GAR. FIREWALL
LATHING 7
MESH
INSULATIONISOUND L
FINISH GRADING
FINAL INSPECTION 1
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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