05217 (SFD)F4
P.O. BOX 1504 No. 0 5 21 T
Building 78-105 CALLE ESTADO
Address 77-005 Fernand* LA QUINTA, CALIFORNIA 92253
Owner a
%a Oninta Joint Venture BUILDING:. TYPE CONST. OCC: GRP..
Mailing
Address
1t . x 7RA A.P_Number e,• -t- Ra"V * ,Z"r—
City Zip Tel. `
i Asx 4,n 4 ,� Sgi-11AIR Legal Description
Contractor Project Description PI=P ss �...,.. • t h _ rf
Address Y
City Zip Tela
State Lic. City
& Classif- 378318 Lic. # g� Sq. Ft. 2586 No. No. Dw.
Arch., Engr., Siie `Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
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 force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affimm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S,Busness and Professions Code: Any city or county which requires a
permit to construct, alter, reprove, demolish, or repair any structure, prior to its issuance also -
requires the applicant for such permit to We a signed statement that he is licensed pursuant to 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 plan Chk. De
for the alleged exemption. Any vnfa.tion of Section 7031.5 by 'any applicant for a permit p
subjects the applicant to a civil penalty or not more than rive hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. �1 541.86 /
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. c C
Professions Code: The Contractor's License Law does not apply to an owner of property who 545 .50
builds or Improves thereon and who does such work himself or through his own employees. Mech, 87.0(11provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical ,
of proving that he did not build or improve for the purpose of sale.) 95.25
(
O, 1 as owner of the property, am exclusively contracting with licensed contractors to con- Plumbkfg 139.00
struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner o1 property who Mohs or improves thereon, and who contracts for S.M.I. 12.92
such projects with a conirddor(s) licensed pursuant to the Contractor's License Law.)
• Grading
❑ 1 am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date,f .r Owner Infrastructure 4,145.67
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.) a
Policy No Company -970,7
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.'
TOTAL 35.667.24 "=
CERTIFICATE OF EXEMPTION FROMY
WORKERS' COMPENSATION INSURANCE REMARKS
(This section need not be completed if the permit is for one hundred dollars ($100) valuation;)�i i ,'. (:_S,•t�_ ,tjS -'.:�"'�i Ail
oil I certify that in the performance of the work for which this permit is issued, I shall not 2. it �ti:i it L t 1i 1 tit. : tom+ , G1Y
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of Califo n a.
Date - " 1- 'Owner
NOTICE TO APPLICANT: ff, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
Comply With such Provisions or this permit shall be deemed revoked. 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
Lenders Name
Lenders Address FINAL DATE INSPECTOR
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. 12/30/88
I certify that 1 have read this application 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
bove
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
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)/ / METER LOOP
HEATING (FINAL)
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT.
WATER HEATER SERVICE
WALL SO. FT.
DRINKING FOUNTAIN
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
LUMBER GR. FINAL INSP./� 2±1 /
WATER PIPING
NOTE: Not to be used as property tax valuation
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/.c
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
OUND 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, , l /��J
GAS (ROUGH)/ / METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
t
BOND BEAM
WATER SYSTEM
GRADING
cu. yd .
$ plus x$
=$
LUMBER GR. FINAL INSP./� 2±1 /
FRAMING /2G �/ FINAL INSP. /G�Jtlt 07
c
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
ccurrc FINAI
00
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REMARKS:
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL