002662 (RER)oce
I 'ity,., 4
3.
P.O. BOX 1504 NO.
Building 78" 138 `a�°hSDtao 78-105 CALLE ORNIA 9
Address LA QUINTA, CALIFORNIA 92253
Mailing
Address
CityZip oad
>� PAIR "03844
Contractor
,. W.E. fx7I.gLO2ierr Inc.
Address
68-530 E. ii&i1
.. S I•} f.. k x i -M
State Lic.
& Classif. .282 830
,,,Arch.,, Engr:, - '-
Designer
Address
%,I Ly
Lic. # f55
Tel.
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number r 1 f
Legal.Description t` ',1 -7 l
Project Description
i i 1 r i1 f \� � i r._ !'1 � . � _-•.-.. � �i .t•r r, , r• �i' a
Sq. Ft. No. No. Dw.
Size Stories • Units' •
New ( Add ❑ Alter ❑ Repair ❑• Demolition ❑
City
. .. . . _
Zip ]State
- . ..Lic.
#
3T d lam applim!C s, uis awe', S aid
arA fe=e mid relocat* gms netAx'
Linc
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed underprovisions of Chapter 9 (commencing with Section'
7000) of Division 3 of the Business and Professions- Code, and my license is in -full force and ,
y
effect., ij�
TM�
and d 6i5 s
' SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the.following°r
. reason: (Sec. 7031.5,Business and Professions Code:.Any city or county which requires a;
Permit to construct, atter, 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) or
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 ($500): ' • ^
❑ I, as owner of the roe
p p rty,_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- i
• struet 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.)
.. O 1 am exempt under Sec.- B. & P.C.-for this reason -
Estimated Valuation p��
}�y tr Slit l3 wiJV
'i;! i.1 iJV
A � -
- PERMIT- .• -
AMOUNT'
- .'�
Plan Chk. Dep...
- _ - .
Plan ,Chk. Bal.
mitts C ,
_-Const.435.50-
Mech.
Electrical -���
'
'
Plumbing, -•t}
.
S. M. 1. - "'
7^04 '
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, ora 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
759.62
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 '
REMARKS-
' 's
NOTICE TO APPLICANT: lt, alter making this Certificate o/ Exemption you should become ' . ZONE: BY:•
subject to the Workers' 'Compensation provisions of the 'Labor 'Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. - 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 permit when properly filled out, signed and validated, and'is subject to -
expiration if work thereunder is suspended for 180 days. _ • `; t ��: �,C3
I certify that I have read this application and state that the above information is correct.. Issued by:. Date "t �' Permit
I agree to comply with all city and 'county ordinances and state laws relating to building a
construction, .and hereby authorize representatives -of,this city to enter the above-. '' •:
mentioned property for inspection purposes. Validated
Signature of applicant V•��/ �? <— ^ �% Date ff� ' r a
Mailing Address +'r
• g Validation:
City, State, zip
B6606 1C 30 759,62 U --
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. 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.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
(ROUGH), 77
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
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.
SQ. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
7—AWS Sfdg� l��
17
IAC 6o.1,.
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE ��' 87
�j�OUGH PLUMB. p-
�/
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
(ROUGH), 77
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
I'll F, 1 ��
AS (FINAL) ���
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM 75- `
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
7—AWS Sfdg� l��
17
IAC 6o.1,.
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
NAL INSPECTION
CERT. OCC.
FENCE FINAL
�narc�, i vn a JIV ISN I vncwmI i iNw_
GARDEN WALL FINAL