003725 (BLCK)I . . --12, - - , , a 44, 0
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-333 A Avenida , V81 sco LA QUINTA, CALIFORNIA 92253 .
Owner
Susan L. Danriar
No. €03725
Mailing
BUILDING:•TYPE CONST. OCC: GRP.,
Address SWDA3
A.P.,Number 774-251-037
City
Zip
Tel.
La fl a
92253
92253-
34689
�3�"
Legal,
Project Description
100 4 of 5.1.. high . bled wall
Contractor
Address
City _ .
Zip ..
Tel.'
State Lic.
City
\No.
& Classif.,
Lic. #
Sq. Ft.
No. Dw.
Size
Stories Units
Arch.; Engr., --
-Designer
New ❑' Add ❑
Alter ❑. Repair ❑ Demolition ❑
Address
Tel.
City
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 3 of the Business and Professions Code, and my license is in full force and
effect. .,
'
- 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,Business 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) or
' 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.
subjects the applicant to a civil penalty of not more than five hundred dollars ($500):
❑ I, as owner of the property, or my employees with wages as their sole compensation, will,. .
Estimated Valuation
S
$2t-100
,
-.: � - PERMIT �
. � � - AMOUNT -
Plan! Chk: Dep..
- -
Plan Chk. Bal.
Const..
- w 50
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 or propegy,who
Mech.
-
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.)
Electrical
Plumbing
.
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
• slruct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner or property who builds or improves thereon, and who contracts .for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
. ❑ I am exempt under Sec. B. 8 P.C. for this reason
1 ..
. S.M.I. -
50
Grading
Driveway Enc.
_Date 7 4 Jt'!' owner i<._ r} ,� 1 _ �k1i.r
Infrastructure
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 tiled with the city. O Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
l .g
,ES;1°'? D :-•e:} �Y. - "il•;—j� J . jai. i';'
(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 thg 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
subject 'to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
ZONE: BY: -
Minimum Setback Distances:
Front Setback.from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
-
Side Street Setback from Centerline
I hereby affirm that there is a construction lending agency for the performance of the '
Work for which this permit is issued. (sea. 3097, Civil code.) -
Side Setback from.Property,Line
Lender's Name
FINAL DATE
Issued by:
Validated by:
INSPECTOR
9 )
Date 311 j�! • 88Permit
Lender's Address
This is a building permit when properly filled out,'signed'and validaled,'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.
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. p
SQ 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 va=uation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
ISEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
VENTILATION
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./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM 3 2�� �g
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/IYITIALS,
GARDEN WALL FINAL