9530 (SFD)• 0 6J .
44a
P.O. BOX 1504 v N o .
Buildii g 44-150 Cr isle) Place 78-105 CALLE ESTADO � t
Address LA QUINTA, CALIFORNIA 92253
- ' La Quints Vista Partnership
Mailing
Address P. 0. Bog 227
City Izip ITel.
Contractor
Same.
Address
Zip
State Lic.
& Classif. . 500316
Arch., Engr.,
Designer
Address
City
LDING: TYPE CONST. OCC: GRP..
P. Number.
!gal Description araot 23269
Project Description
Lic. # 4 Sq. Ft.
Size
New ❑
Tel.
Zip (State
Lic. #
9530
Lot 214 Plan 3
No.
Stories
No. Dw.
Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
! LICENSED CONTRACTOR'S DECLARATION
I O) ofy,ivi irm that l a licensed yhder provisi� of Ch (commencingsin wl'th Section
7000) of`Division 3 o the siness d Profess'on� � efld-my licensefis in fell force and
effect. r do
- -
SIGNATURE DATE
' OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a
Estimated Valuation
123,308.00
PERMIT
AMOUNT
permit to construct, alter, 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 s civil penalty of 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. De �
p.
Plan Chk.. Bal.
598.60
COiISt.
723.50
.do the work, and the structure is not intended or offered for sale. (Seca 7044, Buisness and
Professions Code: The Contractor's License Law does not apply to an owner of property who „� -,
Mech.
6 0
�•� Q
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.)
Electrical \
• ' t - 126.65
Plumbing
138.50
❑ I, as' owner of the property, am exclusively contracting with licensed contractors to con-.
Strutt 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
S.M.I.
8.68
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. - B. 8 P.C. for this reason
Grading
Driveway Enc.
Date owner
Infrastructure
2774.43
Art •ire Public 58.27
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.)
Policy No. Company '
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
REMARKS
'
(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.(
rlifit�i u`3 4A ^.4 "b`i •A'�A � .t5 i f
Y
lfa�+)� A �� x1{k8> 6 {
Date ' Owner
NOTICE TO APPLICANT. If, 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.
ZONE: BY:
Minimum Setback Distances: '
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
Ihereby 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
Lender's Name
FINAL DATE
Issued by:
Validated by:
INSPECTOR
Date Permit
Lender's Address
This is a building permit when property 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
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
COLL. AREA
2ND FL SO. FT.
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
AS (ROUGH /C4..Gjl
DRINKING FOUNTAIN.
SO FT ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
1� GAS (FINAL) ��). ,�
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEWPERM
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 ® 1Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® 314c
HOUSE SEWER
SPARK ARRESTOR
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
UND PLUMBIN J0101
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI Ta . O/
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
nn •
FOUND. REINF.�'1
Vv'' I
AS (ROUGH /C4..Gjl
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
1� GAS (FINAL) ��). ,�
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP/.6 l
MING -� 2.
FINAL INSP.
ROOFING
7
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
(1THING GJ .Ol
MESH
INSULATION/SOUN6`7
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
SFD
CITY OF LA OUINTA
.,X,WMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
may "HI OUR NOTICE FOR INSPECTIONS
Owner --t-d-tU�ia Vista Partnershiip
Contractor SAME
Pwmit Number 9530
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPA ES
JOB ADDRESS 44-150 Cristol _p-la0z
P_ I q '-V
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MA.'v GROUND SYSTEM
WUND PLUMBING VU
PRE-GUNITE
DON91 OUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRSTE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT -A/C
O.K. TO WRAP
t?F
EFILNEIN.119M1.1
PRE -ROOF I I
COVER NO WORK UNTIL ABOVE HAS BEEN SI NED
DRYWALL INTERIOR `7
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FINALS
ELECTRICAL
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
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