04371 (SATT)p K nt. P.O. BOX 1504
Building K. 78-105 CALLE ESTADO
Address '5 5 TanCJ1eW*0 i LA QUINTA,.CALIFORNIA 92253
Owner _1.
su;� rioe conlft=y
" BUILDING:' TYPE CONST. OCC. GRP.
Mailing-
Address-- -75-005, PwoUi try Club DriVe A.P. Number PGA Waith The Greons
City Zip Tel.
Palj t V-081azt 92260 565-2828 Legal Description
Contractor Project Description ft'a^n PhasA 7*
Address ...,
City Zip Tel.
State Lic. City
& Classif. 288130 Lic. # 391 " . a Sq. Ft..No.• 2 No. Dw.,
Arch., Engr.; Size Stories " Units
Designer. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address. Tel.
Y •
City s 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 3of the Business and Professions Code, and my license is in full force and
effect..f _7 ,r
SIGNATURE - 'DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following TiJ'
reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a I
;•_permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also -
•. requires the applicant for such permit to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT ,
K-,-? the .provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of -
Division!3of the Business and Professions Code, or that he is exempt therefrom, and the basis -
`:. forfhe'alleged exemption. Any violation o/ Section 7031.6 by 'any applicant for a permit Plan Chk. Dep. aC _ ct -
r.7 "`subjects the applicant to a civil penafty or not more than five hundred dollars ($500). Plan Chk. Bal. a+ 3U V #97
,•(❑ 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 Const. 4600 50
-Professions Code: The Contractor's License Law does not apply to an owner of property who 39.01)
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 52' ar ��1yy
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical ap i1 V V
of proving that he did not build or improve for the purpose of sale.) ,
❑ 1, 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 'y•Y
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. - 1)' •7 . `'-Y
4 k
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) _
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure $2t487.92
87.32
was CMaA.t IS Z4J s 9110! ,
WORKERS' COMPENSATION DECLARATION Not 3bir]G'a5t=c tune 1, 24. 6
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
❑ Copy is filed with the city. ; ❑ Certified copy is hereby furnished. z"
TOTAL^4 .LA
CERTIFICATE OF EXEMPTION FROM REMARKS '
WORKERS' COMPENSATION INSURANCE
This section need not be completed if the permit is for one hundred dollars S 100) valuation 1' $`Ti' j f S "" t ~ }
or less.) r - ..
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.
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 ,
r
comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: ` r
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 4'
Lender's Name
Lender's Address 01 1
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE IINSPECTOR
expiration it work thereunder is suspended for 180 days. 7/26/89
_
1 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
„ �� WHITE FINANCE, PINK APPLICANT, GREEN - BUILDING, GOLDENROD; ASSESSOR'S OFFICE, HARD COPY = FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT (a b
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. a
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SO. FT. Qt
TEMP. POLE
GROUT
DRAINAGE PIPING
CARP. SO FT. 6
FINAL INSP.
WALL SO. FT. @
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
b plus xb
=b
URINAL
SO. FT. 0
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION b
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL MOOD
SIGN
WASH ER(AUTOXDISH)
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, 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 g I'A c
SEWAGE DISPOSAL
SO.FT.GAR (a 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 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.
b plus xb
=b
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUPESIINITIALS
,
GARDEN WALL FINAL 7d