05072 (SATT)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-448 Tari dewood LA QUINTA, CALIFORNIA 92253
Owner
Mailing "
Address 42-600 Cook St., Saha 200
CityZip Tel- ..
Palm Desert 92260 568-2826
Rational Mortga
Address
State Lic.City
& Classif. 288130 Lic. # 328 .
Arch., Engr.,
Designer
Address I Tel.
CityIZip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
,'I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
k7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effecL r � � j rt f _
SIGNATURE s ' i r i 'DATE
OWNER -BUILDER DECLARATION
1 hereby affign 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, dernoksh, or repair any structure, prior to its issuance also
requires the applicant for such permit to fie 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 penally or 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 of property who
builds or improves thereon and who does such work himself or through his own employees,
provided thatsuch improvements are not intended or offered for sale. ff. however, the building
orimprovement is said within one year of completion, the owner-bur7der will have the burden
or proving that he did not Bold 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 of property who builds or improves thereon, and who. contracts for
such projects with a cordrectar(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. S P.C. lot this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I her affirm that 1 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 (grnpany
❑ Copy is filed with the city. ❑ Certified copy is hereby fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars ($100) valuation
or lass.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ o any person,in any manner sas to become subject to the Workers' Compensation
=any
Calnfomiaf ( Date --_IL .1 Owner k) t
NOTICE TO APPLICANT: ff, after making this.- CbrWicate of Exemption you should become
subject to the workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provcions of this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lenders Address
This is abuilding permit when property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
1 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. 05072
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number PGA West - Phase 32A
Legal Description
Project Description P"n 9CR
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
12,27/88
Issued by: Date Permit
Validated by:_
Validation:
Sq. Ft. 2489
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolit,on ❑
Estimated Valuation
S I70.208
_
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
S . rp�p
!;00. *
Const.
610.5-3 5:3
Mech.
33 .03
Electrical
113.52
Plumbing
111.0.3
S.M.I.
I 1.114
Grading
Driveway Enc.
Infrastructure
$3,829.68 1,914.84
TOTAL
REMARKS
7Aio'Y
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
12,27/88
Issued by: Date Permit
Validated by:_
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. ®
FORMS
OR S
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
fOUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL SO. FT. ®
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$
=$
URINAL
SO. FT.
AMING
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
0 � �
WATER PIPING
NOTE: Not to be used as property tax valuation
REMARKS:
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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
TION/SOUND
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
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
SACK
ROUND PLUMBING f
UNDERGROUND
A.C. UNIT
COLL. AREA
GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
OR S
ROUGH WIRING
DUCTWORK
ROCKSTORAGE
ND. REINF.
fOUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
INAL)
TEMP. POLE
GROUT
WATER HEATER
ERVICELg
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
AMING
FINAL INSP.
00FING
0 � �
/
('
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FFIIREWA
V±WNGk
ME H
TION/SOUND
FINISH GRADING
AL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL