04369 (SATT)44.
P.O. BOX 1504
Building 78-105 CALLE ESTADO 4
Address5 297 '�°angl*�t11 o .. LA QUINTA, CALIFORNIA 92253
Owner w»
1 °3®Co m3Y BUILDING:' TYPE CONST. OCC. GRP.
Mailing
' Address ._.75—_0A5 Ci �C' lY <r�lr M." ter ». A.P. Number PGA West — The raree�e
City Zip. Tel. ,. w .• , M .... _ -
Paim Dessert 92260 w x561 t2,4�-4., _ Legal,Description
Contractor Plan 'C Phase 70
Project Description
Address ...
City Zip Tel.
State Lic. 288130 City 3��3 ,.. , » � .$...... 2
& Classif. Lic. # SO'Ft." "" " " No.' '" " No. Dw..;
Size Stories Units
Arch:, Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City } Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 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 arid.
ri
effect.
SIGNATUREI - DATE
OWNER -BUILDER DECLARATION
Estimated Valuation.
-Thereby affirm that I am exempt from the Contractors License Law for the following
rea3on:•(Sec.. 7031.5,Susiness and Professions Code: Any city or county which requires a
..
It4o Fconslruct, alley, improve, demolish, or repair any structure, prior to its issuance also - "4
-_requires Atha.' licant 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
- sion- 'bfthe Business and Professions Code, or thathe is exempt therefrom, and the basis plan Chk. De -
for the 'alleged exemption. Any violation of Section 7031.5 by any applicant for a permit p 4, .ee.. -
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan' Chk. Bal. y t �te'Fl s.Ar 7
❑ I, as owner of the property, or my employees with wages as their sole compensation, will art G n
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. SIF r' is
.x 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. 391. Liu
provided that such improvements are not intended or offered for sale. If, however, the building tr�{�yya
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical V
of proving that he did not build or improve for the purpose of sale.) 1-8t
❑ 1,"as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 9.9 * 00
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.I. ` 7-14
,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O 1 am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date owner Infrastructure_
utr OO A 46' 1;1 p:yip
WORKERS' COMPENSATION DECLARATION 1 �v A'+iJlrr'i.nYi jrJaRCA
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. 3900, Labor Code.)
Policy No. ' Company
"
O Copy is filed with the city. O Certified copy is hereby furnished. -
T TOTAL A� � � . d r' c•_ . 'c:J 4 I;
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE y'7 �. '� g
(This - section need not be completed if the • permit Is for one hundred dollars (8100) valuation f yy i.1Y Wsi sly f ff
' or less.) - -
I certify that In the performance of thg 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 -
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances:
Front Setback'from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY - Side Street Setback from Center Line '
I hereby affirm.that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, CIvilCode.) : Side Setback from Property Line '
Lender's " Name tt -
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to 1 • -
expiration if work thereunder is suspended for 180 days. 7/26189 1
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-
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing'Address - Validation:
City, State, Zip '
\'\r r WHITE - FINANCE PINK APPLICANT, GREEN -.BUILDING, GOLDENROD ASSESSORS OFFICE, HARD COPY.- FILE
sa.:S.:-.�: {L:'., _.; t`_P�•fi z,.i.:•u x5: �::.. _... r.- -1-: "�i. 1,.-u::<:.._...:.:"lr :h_'•w �rw+}3r'.n...:.': .hK,:'.. a.�.y,•,. !,^,�l. sr^;`:: ::k .Y:.4.. .- ii,f .. ti,�.: .�r:'t 3
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT fp 1 $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. a
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING •
MOBILEHOME SVC.
BAR SINK
POR SO FT. Qt
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Fr
TEMP. POLE
GROUT-
DRAINAGE PIPING
CAR P. SO FT. 0
FINAL INSP.
WALL SO. FT. (d
WATER, SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus xE
=$
URINAL
SO. FT, 0
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
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 C 1'A c
SEWAGE DISPOSAL
SO.FT.GAR rg Vic
HOUSE SEWER
P20 I dhfi?ION
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 GOND. SOLAR
SETBACK
GROUND PLUMBING
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.
$ plus xE
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR -
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
P20 I dhfi?ION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNAIURESIINITIALS
,
GARDEN WALL FINAL