15406 (SATT)44Q
P.O. BOX 1504
Building7&495 CALLE TAMPICO
Address.,501 90 Pasddi se West Dr. ID LA OUINTA, CALIFORNIA 92253
No. 15406
Owner �--—
`•
B.G. Williams
Fieva,143 mens Co
BUILDING: TYPE CONST.
im OCC: GRP. R1
Mailing
Address 42-690 Cook
St. Suite 120
A.P. Number
City Zip
P�+ lm Desert, C
92211
Tel.
f 519; 341-6830
Legal Description toot
1 -Tac rt 28019
Contractor
Project Description SPS,
Apa rtnent Plan 1
Sate
'Senior -Housing
at The Seasons
Address
Zip JTela
State Lia City
& Classif.. $ 493919 Lic. # 1231
Arch., Engr.,
Designer . Stoffgaenl Fuller & ASSCCi.ates
Address I Tel.
City Zip I State
Catheftal City CA 92234 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 Profess_ioncss Code, an/d'my license is.in full force an -d -
effect. ; > I '7 J.k f • .`'�
SIGNATURE - " I` - ' DATE
J OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (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 itsissuance also
requires the applicant for such permit to lila 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
O 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 of property who
builds or 6nproves thereon and who does such work himself or through his own employees,
provided that such unprovements 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
of proving that he.did not build or improve for the purpose of sale.)
❑ 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
such projects with a contractors) pcensed 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
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
P%tcy No. Company -
1`=1 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 the work for which this permit is issued; 1 shall not
employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: ff, 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. .
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
_ HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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
Sq. Ft.
Size
New ❑
No.
9 • Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated valuation $31,424,.00
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from
Rear Setback from I
Side Street Setback
Side Setback from F
FINAL DATE "Itfs
Issued by:
Validated by:
Validation:
1
AMOUNT
277.-68
297.50
49.90
78.82
108.770
3.1.�4
20.410
.00
797.04
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIN; FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS /6 3/9S
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH �J
v,
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
FRAMING /� Zd/
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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 PLUM
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE AA 9.i
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS /6 3/9S
SEWER RSEPTI
ROUGH WIRING
DUCTWORK
ROCK STORAGE
FOUND. REINF. t7 3 Q�
GAS (ROUGH �J
v,
/METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL 3 �J /
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
!j CU. yd.
$ plus x$
=$
LUMBER GR.
FRAMING /� Zd/
ROOFING/6
ow- �p�� ��/6�,/
/I
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING l
MESH
INSULATION/SOUND /
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL