07475 (SFD)P.O. BOX 1504 No. 074,75 -
Building SdAii%# 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
,N: Petersa' Co.
Mailing
Address � � ' i4 Bluff Dr. T
mite Z
City ,.
Zip .
San Di
92130
Contractor
. Address
City
Zip
Tel.:
State Lic. , '
City
& Classif. 3t
Lic. #
E. Arch., Engr.,
Designer,-.
Address `
Tel.
City
Zip
State
Lic. #
Tel.
- BUILDING: TYPE CONST. - OCC. GRP..
,e3Q A.P. Number
��� Legal Description MMS CQt1J1'S8 Lot 35.
Project Description . T1'"8Ct 2489a Plan %A
°;i t(ICENSED!a C NTQACTO S DECLARATION .
I hereby aft m*that I am icensed d ra'� ovisio sof Chapter 9 (commencing with Section
7000) of Divis�o the %Lsiness a%d rot oa Code, and my license is in full jorye and
' OWNER•f3UILD'�R DECLARATION
I hereby'a .firm!ttiat I am exempt from the Contractors License Law fqr the following
rea on: (Seca 031. S, Business and Pro/essiolis Code: Any city or county .which requires a
perigit fo const ct, alter, .improve, demolish, or repair any structure, prior to its issuance also
requhgs the applicant for such permft to lila a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Divisfon 3 0/ the Business and Prolessfons Code, or That. he !s exempt fherelrom, and the basis
for the alleged exemption.. Any violation of Section •7031.5 • Dy 'any applicant for a permit
subjects the applicant to a civil penalty o/ not more than live hundred dollars I$500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Seca -7044, Buisness and
Professions Code:. The Contractor's License .Law does not apply to an owner of property who
Lbuilds or improves thereon and who does such work himself or through his own employees,
,T piovided that.sucb improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of. proving thaf.he did not build or improve for the purpose of sale.)
07I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project.' (Sec. 7044, Business and Professions Code: The Contractor's License Law
t does not apply to an owner o/ property who builds or improves thereon, and who contracts for
t such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) .
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Cort#}p/ensation 1 surance, or a certi ie cop�y4th�erea$f./Sec. 380Q Labor Codta.)•
Polic No..�-' .Company - ! .,"�NtY.. - 3���i_0"�r,�.
Xy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(This section need not • be completed i/ 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 persoq in any manner so as to become subject to the Workers' Compensation
Laws of California 4
Date Owner
NOTICE TO APPLICANT: If, alter 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
r 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
b ' 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 of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. 61 No. No. Dw. - •
Size Stories Units : New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation • - $187s400
PERMIT � AMOUNT •
Plan Chk. Dep.
Plan Chk. Bal.•44
Const. 5 78.00
0
Mach. - -
Electrical. . •_- gib• - # '
Plumbing - IS6 S0
S.M.I.
Grading '
Driveway Enc.
Infrastructure 4.21-64L.
REMARKS -
•l,69f! :d 1:S {Y7— - v>..,'
Ll.' ivi' 1 .K
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
4/2/90
Issued by: Date
�j�� ,•
`1���.
TOTAL
• . �►�ia3�•a88 -
0-_ .
Permit
..
Validated by: .
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO, 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
$O
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH) vy
ex
LAUNDRYTRAY
AIR HANDLING UNIT CFM
OTHER APPJEQUIP.
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ®c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
FINAL INSP(//`- s 4D
SQ.FT.GAR ® 3/4c
HOUSE SEWER
ROOFING 14 q
L,)
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBLTOTAL
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 PLUMBIN ,(y QQ
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE&f
$O
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
LOSEWER OR SEPTIC TAN ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) vy
ex
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEELY//J
/D Tj
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR..
FINAL INSP(//`- s 4D
FRAMING (� /S 7�
FINAL INSP/ Q �A
ROOFING 14 q
L,)
rp/%l �>v Ti,C J�y�
��ll _`7
6 �C(O 7 �
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION) D
! l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL