001952 (SFD)P.O. BOX 1504 No. 001952
Building 78-105 CALLE ESTADO
Address -235 Aximift *elas . LA QUINTA, CALIFORNIA 92253
Owner
-AIM B. RiCh=13dY
- Mailing - ' ,. BUILDING: TYPE CONST. .00C: GRP. R
Address 09 Lrail vi'xX A.P. Number 774-A4-023
City Zip Tel. -
Vaaas , 2-077 1 1.461--6503 • Legal Description
Contractor
WProject Description s 1m. kms!! V I 3
Address .. _
City Zip Tel.. q
State Lic. City
14
& Classif:. Lic. # Sq. Ft. No. No. Dw.
Size Cwt.- 490 '- Stories Units
_ Arch:, Engr.,. . ... .. '
..Designer New C•lpat' o d ❑ 10ter ❑ Repair ❑ Demolition ❑
er
Address Tel.
City Zip State
.. _. .. ... Lic. # . .
LICENSED CONTRACTOR'S DECLAijATION..
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. . .
• .SIGNATURE DATE
r OWNER -BUILDER DECLARATION Estimated Valuation - -
• I; hereby affirm that I am exempt from the Contractor's License .Law for the following 35,406.10
reason: (Sec. 703.1.5;Business and Professions Code: ' Any, city or county. -which. requires a
permit fo 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 : PERMIT•" AMOUNT '
the provisions of the Contractor's License Law, Chapter 9 (commencing with' Section '7000) of �x
Division 3 'of 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 Plan Chk: •Dep.: -
subjects the applicant to a civil penalty of not more than *five hundred dollars ($500):' r„
0.I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Ba.L a7�01
do the work, and the structure is not intended or offered for. sale. (Sec. 7044, Buisness and COr1St,.�
Professions Code: The .• Contractor's License Law does not apply to,an owner of property who •
00
builds or improves thereon and who does such work himself, or through his own employees, -- y lae� `
provided that' such improvements are not intended or offered for sale. If, however,. the building Mech. 1l .00
or improvement is sold within one year of completion, the owner -builder' will have the burdenEI2CtrICdl
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 931.00struct the project. (Sec.�7044, Business and Professions Code: The Contractor's License Law ,ry
does not apply to an owner of property who builds or improves thereon, and who contracts .for S,M,I.,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C..for this reason Grading
S
Driveway Enc. 20.001
Date owners (il,, _ . k't Infrastructure lA�
WORKERS' COMPENSATION DECLARATION
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.'
TOTAL 2,010-45 •1 x'69.95
CERTIFICATE OF EXEMPTION FROM REMARKS.
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
or less.)
., ..
1. 1 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.
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,Llne
Lender's Name
Lender's Address
This is a building permit when properlyilled out, signed and'validated, and is subject.to FINAL.DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. •t �i
I certify that I have read this application and state that the -above information is_correct. Issued by: Date 12-13
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
ypurpo7e s/� Validated by:
Signature of applicantV rr"}'1 ; si i w,> _ ate—0 I
Mailing Address A— "' t t r ' '% ' Validation:
City, State, Zip
A 3 5 7 3 12 13 x.%69,95 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING!=cES ` z
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT,
DRINKING FOUNTAIN
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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.
SQ. FT. RESID ® 11/a c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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
OUND PLUMBING i 0
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. q v�
11 rr
BONDING
HEATING (ROUGH)
STORAGE TANK
`
FORMS �o'tY3
SEWER OR SEPTIC TANK
ROUGH WIRING % r
O
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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 f
O
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/TAI
'4 THING 2 ��
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS•
GARDEN WALL FINAL