06660 (SFD)�.
T� 4
P.O. BOX 1504 No. 06660
Building 78-105 CALLE ESTADO
Address 44-1,55 Sonesta Way LA QUINTA, CALIFORNIA 92253
Owner
riad Pacific insert Dev. BUILDING:, TYPE CONST. OCC: GRP.
Mailing
Address 74-923 Wiley #130 , . A.P. Number. La QuftPa Higb1avAs TT 23264
City Zip Tel.
PRIM Desert 92260 340-9174 A Legal Description
Contractor Project Description 5FD Plm C Lot 24
Same
Address
City Zip Tela
State Lic. City
& Classif. 505699 Lic. # 13$3 Sq. Ft. 1563 No. No. Dw.
Arch., Engr., Size '--Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City 7Zip State
Lic. #
-.n LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that�l am licensed under provisions of Chapter 9 (commencing with Section
70pp) of bivisio :3 of the Business and Pyrofa�sslons Code, and my license is in full force and
effect /f- �7. � .W � ✓?�`7Y r. - t
YI L,
SIGNATURE' ' - �.--.,+" ,+' J DATE
OWNEti-BUILDER DECLARATION Estimated Valuation
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,8usiress and Professions Code: Any city or county which requires a $87,591
Permit to construct, ager, 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 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
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep.
subjects the applicant to a and penalty of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, Plan Chk. Bal. $ 89.0f�
7
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 585-50
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, Mech.�{�{,{
provided that such improvements are not intended or offered for sale. ff. however, the building
or improvement is said within one year of completion, the owner -builder will have the burden Electrical -
101.21
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- Plumbing 120.50
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 brproves thereon, and who contracts for . S.M.I. 6.16- V'
such gimieets with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure 10970.90
WORKERS' COMPENSATION DECLARATION w
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
C�Copy is filed with the city. ❑ Certified copy is hereby fumished. 1
TOTAL
CERTIFICATE OF EXEMPTION FROMr
WORKERS' COMPENSATION INSURANCE REMARKSf3<*tt�
(This section need not be completed fl the permit is for one hundred dollars (S100) 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
NOTfCE TO APPLICANT: ff, after making this Certificate of Exemption you should become ZONE: BY:
subliect to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply With Such Pfoviseorsorthis permit shaft bedeemed revoked. Minimum Setback Distances:
Front Setback from Center.Line
Rear Setback fromNRearProp. 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. (Seo. 3097, Civil Code.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to t
expiration if work It is suspended for 180 days. 11l17�$'�
I certity that I 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 property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address— Validation:
City, State, Tip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE if ZL O
10,
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF. �(
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. ®
WALL SO. FT.
WATER HEATER
DRINKING FOUNTAIN.
FINAL INSP.
URINAL
SOFT ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus xt
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
ROOFINGREMARKS:
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L 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, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE tELECT.FEEl
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING _ ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE if ZL O
10,
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. �(
GAS (ROUGH) ,. �e�/ Qa
[[
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xt
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFINGREMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 01(v "4
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1