9957 (RPL)Building
Owner
• V
4
P.O. BOX 1504 N o .
5D--905 Calle Paloma 78-105CALLEESTADO
LA QUINTA, CALIFORNIA 92253
Pyr. & lore. Merritt BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 50--905.Calle Pajama
A.P. Number
City Zip Tel.
La Qtlinta 92233 Legal Description
POOL. & S
Contragc��o2ifOrni8 $otsls Project Description pa
AAA
9957
r=910 ' Boardwalk, Suite A-3
Ci
atm Desert
Zip
.. 9226th
.:
Te3
40-9000
State Lic.
& Classif. 185102
City
Lic. # 355
Sq. Ft.
Size
No. No. Dw.
Stories Units
Arch.; Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
T }LICENSED CONTRACTOR'S DECLARATION
I hereby affirm khat I aT licensed�yrider provisions of Chapter 9 (commencing with Section
700 01 Divisiont 3 of the{ B/usines"s)and Professions Code, and my license is in full force and
effect t �1
SIGNATURE DATE
%y, OWrIER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
Permit to construct, after, 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) 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 perrnR
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employerees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec: 7044,-Bussness and
Professions Code: The Contractor's. License Law does not apply to an. owner of property who
braids or Improves thereon and who does such work himself or through his own employees,
provided that'such.improvements arenotIntended or offered for.sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
or 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-
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 projeects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Estimated'Valuation
r
$12 4�0
r
PERMIT
'
.
AMOUNT
Plan Chk.:Dep.
Plan Chk. Bal.
f#
93.60 1 tR
3 . 6v
Const.
144.00
Mech.
24.00
Electrical
/S
SP00
Plumbing
2.7 . 00
S.M.I.
1.30
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a' certificate of
Workers 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.
TOTAL 334.90
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one- hundred dollars (S 100) valuation
or less.) .
1 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 Cahpamia
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 w -h such provisions or this permit shall be deemed revoked.. .
CONSTRUCTION LENDING AGENCY
1 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.)
Lenders Name
Lender's Address
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.
1 certity 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
REMARKS
Vi!5, t;; '7
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
8/26/91
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES"
1ST FL. SO. FT. ® $
UNITS
i c
2ND FL. SO. FT. ®
-
YARD SPKLR SYSTEM '
POR. I SO FT ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT. ®
DRINKING FOUNTAIN.
SO. FT.
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
f MECHANICAL FEES
]WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT 1 CFM
^
{ flm fs
T
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
FIRE ZONE ROOFING:
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SPARK ARRESTOR
SO.FT.GAR ® 44c
HOUSE SEWER
d
GAS PIPING
PERMIT FEE 1
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
1
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
-1
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 6 AIR COND. SOLAR
SETBACK I
_
GROUND PLUMBING ;q
UNDERGROUND F a / qt
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. j
GAS' (ROUGH) MOI
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT 1
WATER HEATER
SERVICE
FINAL INSP.
t
BOND BEAM
-
WATER SYSTEM
FINAL INSP.
� 4 I G
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
^
{ flm fs
T
FRAMING
FINAL INSP. ' ` L
ROOFINGI
Prig�� xf ;�Ca (L�
REMARKS:
j
VENTILATION I
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING I
i
FINAL INSPECTION• 0 I A
'7
CERT. OCC. }
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS y
GARDEN WALL FINAL