003766 (PLBG)T-itY 4 6'wQu«rw
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address — 2 Calle aa1mp�.co LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address P. C. BOX 1265
City Zip Tel.
-La ju nta . - .92253- -.56473660
- Contractor
ba'te'iand Constmactlon
Address
BUILDING: TYPE CONST. :. ` OCC: GRP.
A.P. Number 769-081-005
Legal Description
Project Description Seiptic
9111—'b ra 1
-.
' City . .. -
Ccaclulla
Zip . _
92235
Tel.-
398-5544
State Lic.
City
& Classif. 312854
-Size
Lic. # 31 ' .
Sq. Ft.
- • •
No. No. Dw.
Stories Units
.A
.rch,, Engr; .
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition D
Address
TeL
C
City..
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
Iihereby affirm that I am licensed under,provisions of Chapter (commencing with Section
7000) of Division 3`of the Business andProfessions Code, and my license is in full force and
• effect.. j.t .wf^ i
r'•
SIGNATURE -•� DATE
OWNER -BUILDER DECLARATION
I heieby affirm that I am exempt from the Contractors License Law for the followin$20
and,
reason: (Sec.. 7031.5,Business and Professions Code: Any city or county which requires a
�
Estimated Valuation
P/�/�
000
@ 0 "
PERMIT
u
- AMOUNT
' permit to construct, atter, improve, or repair any structure, :prior to its issuance also
requires the applicant forsuch permit to rile a signed statement that he is. licensed pursuant to .
the provisions of the Contractor's License Law, Chapter. 9 (commencing with Section 7000) of .
_ Division' 3 of theBusiness and Professions Code, or that. he-isexempt therefrom, and the basis
• for the alleged 'exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to`acivil penalty of not more than five hundred dollars ($500): -
0 I, as owner of the property; or.my,employees with wages as their sole compensation, will
Plan Chk. Dep.-•
: Plan Chk. Bal.
Const...,
+ytg 'PYA
e
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 of property 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
Electrical
or improvement is sold within one year of completion, the owner -builder willhavethe burden
of proving, that he did not build, or improve for the purpose of sale.) _
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
• strucl 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,
••
such projects with a contractors) licensed pursuant to the Contractor's License Law.) -
❑•I am.exempt under Sec... - B. 8 P.C. for this reason
..
Grading
Driveway Enc.
Date Owner
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
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
s` REMARKS
(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, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California. -
..
{►At„) i z.?�r;a�
.. d
Date . Owner
NOTICE TO APPLICANT: If after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions df 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 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
Lenders Name
Lenders Address
FINAL DATE
INSPECTOR
88
4/1/88
' This is a building permit when'properly filled out, signed and validated, and'.is subject to
expiration if work thereunder is suspended for 180 days.
1 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.
Issued by:.
Validated by:
Date - Permit
Signature of applicant Date -
Mailing Address
Validation:
City, State, Zip
HARD COPY
�
T
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 valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRY TRAY
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
SEWAGE DISPOSAL
/y
/ /
I
SQ.FT.GAR ® 3/ac
HOUSE SEWER
REMARKS:
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.IEQUIP.
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. !- -I
ROOFING
/y
/ /
I
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND .
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I VN'J WUNA I UKLWINI I IALJ,
GARDEN WALL FINAL