05743 (SFD)4
P.O. BOX 1504
Building 76-905 Farn=do LA QUINTA78-105 CCALIFORNIA 92253
Address ,-
Owner La rine-nta Joint Venture .
Address P. 0. 780
City Zip Tel.,ba tuinta 92253 564-1315
Contractor
Sarnia Construction
Address ^
Zip
No. 05743
(e
BUILDING: -TYPE CONST. OCC: GRP.
A.P. Number Santa Rosa Cove
Legal Description Tbt 27
Project Description Pian H, Tract 23813
State Lic. city
& Classif. 3713318 Lic. # Sq. Ft.
Size
Arch., Engr.,
Designer New ❑
No.
Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
City
Zip
State
Side Setback from Property Line
Lic. #
INSPECTOR
Issued by:
LICENSED CONTRACTOR'S DECLARATION
$7,231.75
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 fort
REMARKS
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,and
effect. j _^- """ """` • �~ Z
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SIGNATURE DATE
OWNER -BUILDER DECLARATION
Estimated Valuation L
1 hereby affirm that I am exempt from the Contractor's License Law for the following
�216a5f3�3
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a
ev
hropermitato demolish, orair cthat he s lirior censed issuancealso
requires es tto heappl�tfor'sImprove,
r, signed statementto
PERMIT
AMOUNT
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 Section 7031.5 'any for
Plan Chk. Dep.
the alleged exemption. Any violation of by applicant a permit
`subjects
the applicant to a civil penalty of not more than rive hundred dollars ($500).
Plan Chk. Bal.
n f
V $59.25
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do'4Ae work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.1.049.00
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.
$li.i��
provided that such improvements are not intended or offered for sale.: If. however, the building
,^,
or Improvement is sold withhn one year of completion, the owner -builder will have the burden
Electrical
150.35of
proving that he did not build or improve for, the purpose of sale.)
,u
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
202.50
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does builds improves thereon, for -
t
1.5.19
not apply to an owner of property who or and who contracts
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
vnS•M.I.
Grading
I ❑ 1 am exempt under Sec. B. & P.C. for this reason "
'
Driveway Enc.
I, Date Owner
Infrastructure
4,871.46
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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 ($100) valuation
or less.)
I certify that in the performance of thg 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: N, after 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
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.)
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 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
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:
TOTAL
$7,231.75
REMARKS
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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 5/15/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO.' ELECTRICAL FEES
NO, PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SQ. FT. ®
DUCT WORK
ROCK STORAGE
if
FOUND. REINF. � Z y�
GGG V
MOSILEHOME SVC.
BAR SINK
POR. gQ, FT. ®
REINF. STEEL
GAS (FINAL) TEMP. POLE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SO. FT. ®
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
Cu. yd.
$ -Plus-X$-=$
WALL SO. FT.
LUMBER GR.
DRINKING FOUNTAIN.
SO FT ®
< G�
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
VENTILATION
FLOOR DRAIN
MECHANICAL FEES
FIRE ZONE ROOFING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
li
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.
SO. FT. ® c
BATH TUB
SQ. FT.® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FENCE FINAL
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 PLU 2 , Z ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING v UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 7 ri r �%
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
if
FOUND. REINF. � Z y�
GGG V
AS (ROUGH) ,I METER LOOP
fw ,•,+7
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
Cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FRAMING
y �I
ROOFING 1-
< G�
REMARKS.,
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
�v
FINISH GRADING
FINAL INSPECTION6.
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL