003771 (SFD)P.O. BOX 1504 No. 003T71.
Building 78-105 CALLE ESTADO
Address 's Valasco LA QUINTA, CALIFORNIA 92253
Owner
Coachella Valley LandCo♦. `BUILDING; TYPE CONST: OCC: GRP.
Mailing
Address 247 E. .Tahmitz 'Vav 02 A.P. Number 774 -214 -.022 -
City Zip Tel.
Legal Description
Palm anrincM1920262 322-10,10,
Contractor. v ProjectDescription
+Q#•� YY 1r131A ceE•rx�,r�!► •`a ��a �f''ev;
Address. ..
Same'
City _ Zip Tel:.
State Lic. City
& Classif..- Lic. # Sq. Ft. • �� No. No. Dw.
... _.
A�- . Size Stories• --. -Units
Arch.,' Engr.
Designer New ❑ Add ❑ Alter ❑ Repair ❑. Demolition O
Address Tel. 1701..of 6a • wood fence
City Zip State 428 Garacre
_ Lic. #
LICENSED, CONTRACTOR'S, DECLARATION,
1 hereby affirm that 1 am licensed under provisions of Chapter,9 (commencing with Section - -
7000) of Division;3 of the Business aannd_ %Professions Code, a(nd,my license is in,full force'and
effect.. _�? r.fr9s �+v rd..F fef� t'�'•
SIGNATURE ✓ :" �..l�+" _, LPy ..r -ems. a..• DATE _ ..
OWNER -BUILDER DECLARATION '
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's. License Law for the followingtr
reason: (Sec. 7031.5, Business and Professions Code:. Any city or county . which requires a •. a3.:.a:7 ii` ,
'permit to construct, alter, improve, demolish, or repair any structure, 'prior to its issuance also ..:r•.. -
requires the applicant for such permit to. file a signed statement that be is licensed pursuant to PERMIT '- — - AMOUNT
the provislons of the Contractor's License Law, Chapter. 9 (commencing with Section 7000) of
Division 3 of the 'Business and' Professions Code,' or thathe is ekempt 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 five hundred dollars (8500).
Plan. Chk. Bal. ! 1 �t
0-,1, as owner of the property, or my employees with wages as their sole compensation, will � � •. J9 w Jl4t
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and ✓ q,�r ,{ ®�
Professions Code: The Contractor's License Law does'not.apply to an owner of ,property who Const. - • — 36 4
builds or improves thereon and who does such work himself or through his own employees, .Mach ` ��
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 wilVilave the burden EIE'CtrlCal. - 7.4 �- �:7
of proving that he did not build or improve for the purpose of sale.) .. - w
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-- Plumbing.
struct the. project: (Sec: 7044, Business and Professions Code: -The Contractor's License Law q
does not apply to an owner of property who builds or Improves Thereon, and who contracts for S. M. j, - -wJ. -
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - -
O I am exempt under. Sec. • B: & P.C. for this reason Grading 2o.00
Driveway Enc. 20.00
Date owner Infrastructure 1.6887
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.)
Polley No. . . .. Company -e
.. .0 Copy is filed with the city.. CCertified copy is hereby furnished. ,
TOTAL
• CERTIFICATE OF EXEMPTION FROM REMARKS v
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation - .z,• -;p; s•, d n; pa tC a+i^ .fia� Pay .e3r.'s?'
or less.)
_ n. w«yITi s
1 certify that in the performance of the work for which this permit is issued, I shall not 0 •'CA.aFe 9 A -
employ any person in any -manner so as to•become-subjectto 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 We' 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
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 .
-This-is-a building permit when'properly'filled out, signed and validated, and is subject to FINAL -DATE INSPECTOR
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-.
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
n T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT.
SO FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
SLAB GRADE /Ir
/49
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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
WATER HEATER
S0. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® 3/ac
HOUSE SEWER
GRADING
cu. yd.
$ -Plus-X$-=$
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
NIECH.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 /Ir
/49
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
i
SEWER OR SEPTIC
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. / `S .v Q0 J
l C/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEGUIP.
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.
�RAMING
FINA SP.
ROOFING S !
VENTILATION
�/✓ Q'
l
1"
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALLV/.
LATHING `t- "�/ Z�
MESH
INSULATION/SOUNC(O// 7 X�(
CCC���JJJ
FINISH GRADING
(�IFINAL INSPECTIO err
CERT. OCC.
FENCE FINAL -
'
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL