15451 (SATT)P.O. BOX 1504
Building__^� 78-495 CALLE TAMPICO
Address S0-925 Para se FaSt'DZ. 3 LA QUINTA, CALIFORNIA 92253
Mailing
Address 42-600 Cook St. Suite 120
No. 15451
LDING: TYPE CONST. VX OCC: GRP. R1
P. Number
City lZip I Tel. '?t 1 4" & 20019
Palm Desert,
Contractor
Same
Address
Zip
92211 46:19$ 341--6800 Legal Description �� rac
Project Description SPA Apartment Plan, 1
Senior Housing at The Seasons
State Lica City
& Classif. B 493919 Lic. # 1231
Arch:, Engr., r...
Designer Stoffigren Fuller & Associates
Address I Tel.
CityZip State
Cathedral. Ci`ty. 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.8usiness and Professions•Code, and my license is in full"force and.. --
effect.
-1• ). rr 1 /-/ (j 'j lz
SIGNATURE .7� -- - DATE
1% OWNER -BUILDER DECLARATION
I hereby affirm that 1 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, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for suchpermit to No 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 Man 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 of property who
builds or Improves thereon and who does such work himself or: through his own employees,
provided that such improvements are riot 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 irnprove 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 knproves thereon, and who contracts for
such projects with a coniraclor(s) #censed 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 lave' 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 ty No. Company
11 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed 9 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, 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 mak6g 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 ORCOMPENSATION,
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 160 days.
I certify that 1 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 R op. Line
Side Street Setback��rq Ce er Line
Side Setback fromIPr perty _
FINAL
Issued by: Date' % berm
Validated by: c� 19
Sq. Ft.
Size 609
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$31t,124.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
2.71.. 68
Const.
297.550
Mech.
49.00
Electrical
78.82
Plumbing
106.60
S.M.I.
3.14
Grading
20.00
Driveway Enc.
e00
Infrastructure
707.0-4 .
TOTAL _
1,535.18
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from R op. Line
Side Street Setback��rq Ce er Line
Side Setback fromIPr perty _
FINAL
Issued by: Date' % berm
Validated by: c� 19
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS °�
c
SEWE OR lg�
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
S RO GH) n
O�
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT.
GROUT
WATER HEATER
WALL SO. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. �/G
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SO. FT. ® c
BATH TUB
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ec
HOUSE SEWER
FINISH GRADING
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
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS °�
c
SEWE OR lg�
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
S RO GH) n
O�
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. �/G
FRAMING / 9�
J
FINAL INSP.
ROOFING �(j �3 9
o� �/
��/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION /
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL