04429 (SATT)' - i .' • �. -k �.
4 �I Lf 044-2-9
` P.O. BOX 1504
Building 55-057 Tanglewood- - . ,,LA QUINTA, CALIFORNIA 92253
Address
Owner a
' •; _G9,iMA5,.isa coupan.T K i .++. s �. it a. r y.- r• � , •l - •
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address 75-005 COUntrY• Cl Drive A.P. Number PGA West The Greens �<
City Zip Tel.
Palm se 92260
Legal Description
Contractor - Project Description Phase 4ca "'_ Plan AuR +
National Mrtaaere
Address '
�i!?[Ta1R4 "a
City Zip Tel.
u .
State Lic. City
?£ Classif. 288130 Lic. # 39 Sq.Ft., _ No. . , No. Dw:
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑. Repair ❑ i Demolition ❑
Address Tel.
City Zip State
• 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 Business and Professions Code, and my license is in full force and
effect.
SIGNATURE - DATE '
OWNER -BUILDER DECLARATION Estimated Valuation p !�}
I hereby affirm that I am exempt from the Contractor's License Law for the following ei 319
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a m
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 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 civil penalty of not more than live hundred dollars (S500).
Plan Chk. Bal. «+.3,f 0I
❑ I, as owner of the property, or my employees with wages as their sole compensation, will 'i +
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 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. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical . -
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 1 0 VU
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 S'•M•1. 4 -STA
such projects with a contractors) 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
WORKERS' COMPENSATION DECLARATION Wet =rasta= IzMfre o54
1 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
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL�+�i�tClW!�!"l}
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE t �'/-:,�y /1� i 8 r�
(This section need not be completed it the permit Is for one hundred dollars (5100) valuation
or less.) ;A�V "1'1..i�IIE�°«f-.v '
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: If, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions .of the Labor' Code, you must forthwith Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked. . • r
Front Setback from Center Line
Rear Setback from Rear Prop. Line
corlsTRucnoN LENDING AGENCY Side Street Setback from Center Line"I
I hereby affirm that there is a construction lending agency for the performance of the whic
work for h this permit is issued. (Sec. 3097, Civil code.) Side Setback from Property Line
Lender's Name
Lender's 'Address
This Is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE IN PECTOR
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.' 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-
'..
bove . mentioned property for inspection purposes. Validated by: -
Signature of applicant Date
Mailing Address Validation:
'City, State,' Zip
ti.
r WHITE - FINANCE, PINK 'APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
4-.� 'kr •.. �.-:L..... 1*' a ._ ., .. �.+'r- 4>•. .., -:"?. .l• _ .. ,... ... .. _.,r. _ _ s. _. _:. .. _. .. u.. _._... _C _... <s`I. .., � _ .. J�..
CONSTRUCTION ESTIMATE
- NO. ELECTRICAL FEES
NO. PLUMBING FEES
tST FL
2ND FL
POR
GAR
CAR P.
WALL
ESTIMATED CONSTRUCTION
SO FT !p Z
UNITS
ROUGH PLUMB
SO FT. a
YARD SPKLR SYSTEM
MOBILEHOME SVC.
SO FT.
BAR SINK
4T
SO. FT. Qt POWER OUTLET
ROOF DRAINS
50 FT. �
DRAINAGE PIPING
SO. FT.
DRINKING FOUNTAIN
SO. FT. a
URINAL
VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
GROUT
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISHI
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
=5
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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 ( i V; c
SEWAGE DISPOSAL
SO.FT.GAR @ 4c
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 8 AIR COND. SOLAR
SETBACK
GROUND PLUMB NG
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
E -plus-x$
=5
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
>1 PECTION///
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
-
GARDEN WALL FINAL