15455 (SATT)Building ,,,.-," �_«
Address5O 59D ]�rPafiidi 6ei3 t ,;D�t..13
Owner
S.G. Williams Development Cusp
Address f�
4�"�0 Cbt3;t;St. Suite 120
City Zip Tel.
1�a.1,m Desert, CA 92211 (619) 341-6880
Contractor
Sade
Address
P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Zip I Tel.:
State Lic. City
& Classif. B 493919 Lic. # 1231
Arch., Engr.,
Designer Stoffgren Puller Associates
Address Tel.
68-487 E.. PAI:; Canyon (619)328-180.1
CA -pedal rft1, 1Z&
92234 StaleLICENSED CONNTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3� pof the Business and,Professions Code, and my license is in full force and.,...
effect. :a
,cd- .-1,,,(. s `�":� •- : ,:
SIGNATURE / DATE
1 OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors 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 such permit to file 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).
❑ 1, 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
builds 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 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.)
❑ I, 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 or property who builds or improves thereon, and who contracts for
such projects with a contractor(s) (loaned 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.)
Pocy No. Company
IAO Copy is filed with the city, O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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, I shall not -
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Dale Owner
NOTICE TO APPLICANT: t, 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.
1 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
No. 15-455
LDING: TYPE CONST. OCC. GRP. 111
P. Number
Legal Description Lot 1 Tract 28019
Project Description SFS 4 Apartment Plan 2
Senior Housing at The Seasons
Sq. Ft. No. No. Dw.
Size 622 'Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation $4.2,415.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
323.66
Const.
369.09
Mech.
49.00
Electrical
82.27 -
Plumbing
108.00
S.M.I.
4.24
Grading
20.00.
0.00.Driveway
DrivewayEnc.
.00 ..:
Infrastructure
954.34
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from
Rear Setback from
Side Street Set
ba
Side Setback fr
FINAL DATE_
Issued by:
Validated by:.
0
ne
-i,,ne
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMWh`U FEES 1'
IST FL. SO. FT. ® $
UNITS
"
ROUGH PLUMB.
`BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS !�' ��
SEWE ORA0710W
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEATER
WALL SO. Ff.
FINAL INSP.
DRINKING FOUNTAIN.
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
"
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING /G 9
FLOOR DRAIN
MECHANICAL FEES
p�
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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 a 11/4 c
SEWAGE DISPOSAL
INSULATION/SOUND
FINISH GRADING
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
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE G
ROUGH PLUMB.
`BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS !�' ��
SEWE ORA0710W
ROUGH WIRING
DUCTWORK
ROCK STORAGE
FOUND. REINF.
GH)
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.
I FINAL INSP.
FRAMING /G 9
FINAL INSP.
ROOFING /D 23
p�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION �9G
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE&INITIALS
GARDEN WALL FINAL