04365 (SATT)TA
P.O
'r Buildingt, l" ''" 78-105
Address. ��' M363 ;Ttng1,t86 oo4 LA QUINTA,
-owner ,
; Mailing - '
Address.:' - 7'.x""005 Country Club Drive
City Zip Tel. d;
1 92260
PaL�A Desert
Contractor
WA
State Lic.
& Classif.
Arch., Engr.,
Designer
Address
l
28933
1
, 5
BOX 1504
CALLE ESTADO - Al
CALIFORNIA 92253
BUILDING: TYPE CONST. OCC. GRP.
A.P.-Number The Gro�„na
t � � - + ••
Legal Description
Project Description v `Plan sC — Phase 7G
Tel.
City
Lic. # 33 .. Sq. Ft.. p .1700. No. 2 No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Tel.
City( Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7010) of Division 3 of the Business and Professions Code, and my license is.in full force and
effect. 4 _ f
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,Buslness and Professions Code: Any city or county which requires a
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 o/ 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 penalty of not more than live hundred dollars ($500). `
❑ I, 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 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.)
❑ 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ l am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
X87•'92
$2087,92
t
Estimated Valuation $110v574
110v574
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
• biy
Mech.
• 431
Electrical
40 y 80
Plumbing.
^
S.M.I.
7 * 74
Grading
or less.) +
. I certify that in,the performance of the work for which this permit Is issued, I shall not�
Driveway Enc.
Date owner
Infrastructure
X87•'92
$2087,92
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
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
• r
TOTAL
Esse n. a r .•. ��t� Lt._j
REMARKS
^
y CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section not be completed if the permit Is for one hundred dollars ($100) valuation
r 5 1
f}yj"�"i,'44'`.; 110 ••1188 4�q•^^A�7-81'1.
or less.) +
. I certify that in,the performance of the work for which this permit Is issued, I shall not�
r• c f
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, Civil code.)
Side Setback from Property Line -
Lender's Name
Lender's Address+
FINAL DATE
Issued by:
INSPECTOR'
7/26/89
Date Permit
This is a building permit when properly 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.
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
v "Malling Address
`Validation:
GOLDENROD ASSESSOR'S OFFICE HARD COPY - FILE .t
fl
.y _i!, `.i. o f..... s. ueil_".�a,.. .. .i-_ .-..} .i _ -v4�2. •i _. re..: S+. . _.`f -I�f. .. .
City, State, Zip i
WHITE -FINANCE PINK APPLICANT, GREEN -BUILDING,
t
_. r.....{,5�`., .C.C1.".kms#)�. Y! .... wuS ,�.r..... . '!'.'B. .v Kr:re..,. ... ..L7 .f'. .. at..: f,.. t� ..�
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO F1 (a S
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. a
FORMS
SEWER OR SEPT•C TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
GAR SO. FT. C1
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO FT. Cr
GROUT
WATER HEATER
WALL SO. FT. a
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. 9
=S
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION S
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT. B.T.U.
SO. FT. RESID (a I'A c
SEWAGE DISPOSAL
SO.FT.GAR g 3/.c
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
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPT•C 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.
j plus x$
=S
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR'
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
IN ECTIO
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATU iESIINITIAlS
GARDEN WALL FINAL