002457 (RER)4 Sep QUM&
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 7S--1.54 0ar► rfJ tr LA QUINTA, CALIFORNIA 92253
Owner
14 1`
Mailing
Address
City I Zip Tel.
Contractor
0
.Address
tic
City Zip Tel.
2214
State Lic. City
& Classif. Lic. #
Arch., Engr.,
Designer
Address I Tel.
City I Zip I State
Lic. #
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. .
IGNATURE• DATE
i` OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec_ 7031.5,9usiness and Professions Code: Any erly or county which requires a
perreit to construct, aller, tmpiove. demolish, or repair any Vruclure, prior to its issuance also
requires the applfcar+l for such permit to file a signed slatemenl that he is licensed pumuanf to
the provisions of the Contractor's License Law, Chapter 9 jcommencing wNh Section 7000) of
bivisiOn 3 of the Business and Professions Code, &that ha is exempt therefrom, and the basis
to the olizVd exampb'on. Any violation of Section 7031.E by any applicant for a perm#
subjects the epplicanf to a-clvd penaNy of nor more than five hundred dollars f$5001,
❑ 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, Bussness and
Profesatons Code: The Contractor's License Law does nut appty fo an owner DI property who
builds or kriprbves thereon and who does such work himseil (V through his own employees,
provided that such improvements are nor Inlendod or offered For sale. ff. however, the building
or improvement is sold within one year of corrplatim, the owner -budder WM 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. ❑ 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 (S100) valuation
or less.)
1 oertlfy 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., it. alter making this Cadilacare of Etemprlarr you should become
subject to the Workers' Componsaflon provisions of the Labor Cade, you must forthwith
comply with such provisions or this Permit #hail be deemed revoked,
CONSTRUCTION LENDING 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.)
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 la 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 of applicant _ —_Date
Mailing Address
City, State, Zip
No. 002457
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number nz
Legal Description TQt ?�
Project Description
Sq. Ft. No. No. Dw,
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
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 DATE
INSPECTOR
Issued by:
Date , r .Permit
Validated by:
Validation:
HARD COPY
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO, FT. ®
SQ. FT. ®
SQ. FT.
SQ. FT. ®
SO. FT. @
SQ. FT. ®
SQ. FT. @
VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
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
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
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.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIG NATLIRESlINkTfAI.S
GARDEN WALL FINAL
W.E. Colglazier, InC. General Building Contractor
July 9, 1986
Mr. and Mrs. Ed Nicholson
78-154 San Timeteo
La Quinta, California 92253
Mr: Hal Broderick
Interior and exterior revision to an existing residence.
Removal and replacement of all walks, driveways, swimming
pool and Jacuzzi. 'New pool patio to,be washed Terrazzo.
Remove and install wood swinging doors on the patio front gates
and doors. Doors to be furnished by Mr. Broderick.
Remove and replace Quarry Tile in entrance and kitchen area. New
tile as selected by Mr. Broderick. Install allowance is.$10.00
per sq. ft.
Remove doors and casings over recessed T.V. areas.
Install new Med Co locks. Finish hardware allowance is $2,500.00.
Lower existing bar top. Install Jurparana granite on existing
bar tops and on new back bar cabinet installed by other.s.
Install reover existing sundeck.' Remove one
existing door to sundeck and remove wing walls at door recess..
Install back mirrors full height and width in his and her master
bath, powder room and.2nd floor bath.
Install roof gutters around pool patio, den, living room, dining
room and kitchen wing: Down spouts will be concea.led where possible.
CA LICENSE NO. 282830
68-530 East Palm Canyon Drive, Suite 3 Cathedral City, California 92234 Area Code 714 • 328-2659 i 328.4069
W.E. Colglazier, Inc. General Building Contractor
An allowance of seven thousand dollars for electrical revisions
is included in the estimate.
Underground drains will be installed in -the pool patio and at the
street curb. Drains will be connected to a '20' deep drywell
in the front yard.
A new 401x10' swimming pool anda new relocated 61x9' Jacuzzi'
pool will be installed. Both pools will be fully tiled with
1"xl" Black Mosaic.Tile.
Existing garage doors are to be replaced with overhead sectional
metal doors. All doors are to be insulated. Existing door
operators will. be re -used.
All existing wood window surrounds are to be stuccoed to match
existing exterior stucco walls.
Install new second floor bath and connect to existing rough -in.
----
CA LICENSE NO. 282830
68-530 East Palm Canyon Drive, Suite 3 Cathedral City, California 92234 Area Code 714 • 328-2659 / 328.4069