05740 (SFD)Building
Address
Owner
(&4 4 SaQ�w
La Quinta Joint Venture
Mailing
Address P. 0. Box 780
City lZip Tel.
P.O. BOX 1504 No. 05740
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Contractor
BY:
Barrila Construction
Distances:
+Address
Front Setback from Center Line
Sze t 2510 '
City
Zip
Tela
Alter ❑
Repair ❑ Demolition ❑
FINAL DATE
State Lic.
City
1Lic.#
& Classif. 378318
189 -
Arch., Engr.,
Designer
Address
Tel.
CityI Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7008) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.:�-r
SIGNATURE DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reasom (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
Permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the appfkant for such permit to file a signed statement that he is licensed pursuant to
the Provfslorms o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
aWsiorm 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($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. (Sec. 7044, Buisness and
Professions Code. The Contractor's License Law does not apply to an owner or property who
brriilds 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. If, however, the building
or improvement is said within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Processions -Code: The Contractor's License Law
does not appy to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractors) 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
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No company i
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.)
1 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
alifornia.DateOwner
NOTICE TO APPLICANT: IF, after making this Certificate or Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
coney with such Provisions or this Permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there is a construction lending agency for the performance of the
work far which thus permit is issued. (Sec. 3097, Civil Code.)
Lenders Name
Lenders 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.
1 certify that 1 have read this application and state that the above information is correct.
1 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 Add ---
City, State, Zip
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number Santa Rosa Cove
Legal Description _ rs
Project Description Flan A. Tact 23313
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Sze t 2510 '
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
FINAL DATE
INSPECTOR
Issued by:
Date5115/89 Permit
Validated by:
Validation:
r
Estimated Valuation
$179,534
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ 742.16
Const.
919.50
Mech.
87.00
Electrical
129.35
Plumbing
202.51
S.M.I.
12.60
Grading
Driveway Enc.
Infrastructure
4.039.52
TOTAL
REMARKS
rml f+ k ru tx 't t -a -'4`i .xt�n_r.t a r; r r S ft
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:
Date5115/89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
SLAB GRADE 6 (
YARD SPKLR SYSTEM
2ND FL. Sp. FT. g
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
SEWER OR SEPTIC TANK ROUGH WIRING
GAR. SQ, FT. ®
POWER OUTLET
ROOF DRAINS
//,
GAS (ROUGH)
DRAINAGE PIPING
CAR P. I SQ. FT.
HEATING (FINAL)
OTHER APPJEQUIP.
WALL SQ. FT.
DRINKING FOUNTAIN.
TEMP. POLE
URINAL
SQ FT ®
GROUT
ESTIMATED CONSTRUCTION VALUATION $
SERVICE
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP. ,
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ING
2
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® I % c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3Ac
HOUSE SEWER
LATHING - IVIN Il
MESH
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 6 (
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. C7 A f
//,
GAS (ROUGH)
01 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.$
Iff
ING
2
y/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING - IVIN Il
MESH
INSULATIONISOUND Ll
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
k