04366 (SATT)• '`r, ~s: . , P.O. BOX 1504.
Building..rJ'� ��@tC 78-105 CALLE ESTADO
' . Address. z LA QUINTA„ CALIFORNIA 92253
'Owner
BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address 75-005 Country Club Dr. _ A.P. NyMber PGAN West — The G^eana
City Zip ITel.
Y�a� Desort 9226 ,5W!2QZQ r . Legal Description
Contractor - Project Description P a3 CIt " Phaco 70
National Horteracre
Address
A,
s.fla4f
City Zip Tel.
State Lic. City
& Classif. 288130 Lic. #, ��� � � Sq., Ft_ , .1700 . , No., � No. Dw.'
Size Stories Y Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State n `
Lic. #
LICENSED CONTRACTOR'S DECLARATION i.
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. • , ",
'` ;rte ,d s t r y ,
SIGNATURE - DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following $110o574
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, atter, 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 i the; alleged exemption. Any violation ,of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.,i300,97
jjA [�yy �r
-
!.subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. BBI.? V Q' 7 7
1;4s owner. of the property, or my employees with wages as their sole compensation, will 460.50
/� 0p�
• do the work; and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. �lR� V • �®
' - Professions. Code: •The Contractor's License Law does not apply to an owner or property who y0I� 0
builds,'or-improves thereon and who does such work himself or through his own employees, Mech. ,,JJd 0
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 wfll have the burden Electrical 68.00
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 ".99.00
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 a 74
such. projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Dale owner Infrastructure.
�i:X AY A. S,atv,r t ti.. Oil # e6.. •sad • ✓ `W
WORKERS' COMPENSATION DECLARATION %V5 TAS It-l&A tox V 14.116"A. t
•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. - - --
TOTAL x?ur J -ZNQ .C4 s
CERTIFICATE OF EXEMPTION FROM REMARKS t
WORKERS' COMPENSATION INSURANCE tw ri 1• x $" S tf # ' r(
(This section need not be completed if the permit Is for one hundred dollars ($100) valuation
or less.)
I certify that In the performance of the work for which this permit is issued, 1 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: g, 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. - -
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 r c
.Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE 6NSPiECTOR-
expiration it work thereunder is suspended for 180 days. t
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 ,
t w� r AY WHITE - FINANCE PINK - APPLICANT, GREEN = BUILDING GOLDENROD - ASSESSOR'S OFFICE HARD COPY - FILE
a r,,. _.:i. ?:.rt .. ... -4:.. :r!'S:-. .... ,y. _'.d r.....,�xv-i=...-►.`.x'. .. ,..:s. -•Y' .., ....r,+':s„:: ..,.+.. -. .�� ..'>...-..-_-...1-.. ._. .. ri. •'t-i�, y1�.,.u��vY- � -.-.�y v,-i�l<�r ..�`t:
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO Fl ra $
UNITS
SLAB GRADE
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. C
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
GAR SO. FT. fpr
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO FT. fd
GROUT
1
WALL SO. FT. (a
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO FT @
_$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
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
WASH ER(AUTONDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
ILAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
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 I V. c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/.c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
NST. FEE ELECT. FEE
T
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 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 x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR -
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
IN+ - CTI
CE . OCC.
FENCE FINAL
INSPECTOR'S SIGNATLRESIINITIALS
GARDEN WALL FINAL