05878 (BLCK)4
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 76--885 Fimrnamdo LA QUINTA, CALIFORNIA 92253
La Quiata Joint Venture
Address F.0. Box 780
CityLa Quinti IZip'93253 ITeI.
Contractor
Aarrile Cous>truaction
Address
No.
ILDING: TYPE CONST.
'. Number S=ta Rosa Cove
OCC: GRP..
Y'» . • . Legal Description
Project Description 3' of 10 Blk 'Wall
.rry
BOB0
P.O. ftm 1540
City Le Qui to
Zip 92253
Tela
State Lic.
& Classif. 378318
City
Lic. # 189 , •
Sq. Ft.. _
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
. LICENSED CONTRACTOR'S DECLARATION s
I hereby affirm that 1 am licensed undtir Provisions of"Chapter 9 (corm4ncing with Section
7 fW) of Division 3 of the Business and Professions Code , and my ligfinse is in full force and
I ,reffect.`.fr l-,' ) r /// `,, / N /
r
I. SIGNATURE DATE
OWNER-BUICDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a
permit to construct, after, hprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
Me provisions of the Canhactoes 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 exempWn. Arty viWation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a c" penally of not more than rive hundred dollars ($500). �
~ ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will
Estimated Valuation
fi;
%
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.,
(�' Q
fff do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The ConbaGa's License Law does not apply to an owner of property who
Mech.
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. It, however, the building
Electrical
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not txdd or irprove for the purpose of sale.)
Plumbing
❑ 1, 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
S.M.I.
.tf"
/ 7i
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Grading
Driveway Enc.
Date owner
Infrastructure
i�
! WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent'to self-insJre,„or a certificate of
Worker's Compensation Insurance, or a certified,popy thereof. (Sec�13800, Labor Code.)
Policy No. Company r _' --.
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
1
TOTAL
r
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCEIN
!, (This section need not De completed if the permit is for one hundred dollars ($100) vatuation
REMARKS
a or less.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ any pornersiaon in any manner so as to become subject to the Workers' Compensation
Laws of Calif
Date Owner
NOTICE TO APPLICANT: It, after makhg 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.
ZONE: BY:
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 Address
FINAL DATE
Issued by:
Validated by:
INSPECTOR
5-'14. 39
Date Permit
This is a building permit when property filled out, signed and validated, and is subject to '
expiration if work thereunder is suspended for 100 days.
1 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
Validation:
City, State, Zip
• 'a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
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
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID @ I V4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3;4c
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 APPJEOUIP.
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 SIGNATURESIINITIAIS
-
GARDEN WALL FINAL
I