06817 (SPIN)P.O. BOX 1504 No. 06817
Building 78-105 CALLE ESTADO
Address 55-900 P" Uvd. LA QUINTA, CALIFORNIA 92253
Owner
Mailing L
M&Mrk Lind Company BUILDING: TYPE -CONST. OCC: GRP.
Address P. 0. Box 1000
A.P. Number FGA West
City Zip Tel.
La QuImts 92253 Legal Description
Contractor Project Description Bleachers for 1990 Satins Gme
Mike Brom Grandstands, Inc.
Address
P. 0. Box 1700
City Zip Tel:
Monrovia 91017 819-357-1161
State Lic. City
& Classif. 275818 Lic. If Sq. Ft. No. No. Dw.
Arch., Engr., Size "Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. If
LICENSED CONTRACTORS DECLARATION
I hereby affirm that 1 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
effecI.
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License law for the following ��,,
reason: (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a
permit to construct, after, improve, dernafsh, or repair any shuchme, prior to its issuance also AMOUNT
requires the appAcant for such permit to tie a signed statement that he is licensed pursuant to PERMIT
the provisions of the Contractors license Law. Chapter 9 (commencing with section 7000) of
Division 3 of the Business and Pro/essixns Code, or that. he is exempt therefrom, and the basis
for the afteged exemption. Any violation of section 7031.5 by -any applicant for a permit Plan Chk. Dep.
subjects the applicant to a cM penally of not more than two hundred dollars (5500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
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, Mech.
provided that suchrrprovements are not intended or offered for sate. 8, however, the building
or improvement is said within one= -year of completion, the owner-buider will have the burden
of proving that he did not build of irpmve for the purpose of safe.) Electrical
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
struct the project (Sec. 7044, Bis -mess 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 S.M.I.
such projects with a contractor(s) itemised pursuant to the Contractors License Law.)
Grading
❑ I am exempt under Sec_ R. & P -C. for this reason
Driveway Enc.
Date Owner Infrastructure
Kisc. $100.00
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 fumished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the pend is for one hundred dollars (5100) valuation t.r;C t f':•l 4 (► x'�d''' f11 -f- Ai)
or less.) '
I certify that in the performance of the work for which this permit is issued, I shall not ti CFt �� ! Fitt} • Uu
employ any person in army manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT: 11, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Cor pendtim provisions of the Labor Code, you must forthwith
comply with such Provfstomsorthis Permit shaebedeemedrevoked- 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, OW Code.) Side Setback from Property Line
Lender's Name
Lenders Address FINAL DATE INSPECTOR
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days. 1/10/90
1 certify that I have read this apptication and state that the above information is correct. Issued by: Date Permit
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 Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
( NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
( YARD SPKLR SYSTEM
2 ND FL. SO. FT. ®
FORMS
SEWER OR SEPTIC —ANK
ROUGH WIRING
MOBILEHOME SVC.
I BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
-$
LUMBER GR.
FINAL INSP.
URINAL
SO. FT. @
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3Vac
HOUSE SEWER
CERT. OCC.
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 —ANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL
1