003827 (SFD)P.O. BOX 1504 No, 003827
Building 78-105 CALLE ESTADO
Address 54"-726 Zi1S;re3" ess LA QUINTA, CALIFORNIA 92253
Mailing
Address 1�;«.l(t1f2S f°.�+,txa�wcf I csTn ttr�x x>ro�
City Zip --� -- - Tel. -
'PaI n Desert .. 92260 568 -2829, -
Contractor
National Mrtaaae
Address
. . Zip
State Lic.
k& Classic. 2,,,3,
Arch., Engr.,
'Designer
Address
Tel.
City
Lic. # 328 ,
Tel.
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number D>fl-A T4ft.!*1'
Legal Description
Project Description Phase 248a Plan I0M
Sq. Ft. DWG 2272,No. No. Dw.
Size f+AR -'Sf2 Stories Units '
New ❑ Add ❑ Alter ❑ Repair ❑ - Demolition O
CityZip
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
Estimated Valuation
y5v��
'
.. -
PERMIT - AMOUNT
11
permit to construct, alter, improve, demolish, or repair any structure, prior tc its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
Meprovisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
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 or not more -than five hundred dollars ($500).
O 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
Professions Code: The Contractor's License Law does not apply to an owner of property who
.,"Plan Chk. Dep.'
Plan Chk. Bal.
Const. -.„
Mech. �r
I;:; _ An
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 1�
or improvement is sold within one year of completion, the owner -builder wiQ have the burden
of proving that he did,not build or improve for the purpose of sale:)
Plumbing Is +3Q qn
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct• 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
- -such projects with a contractors) licensed pursuant to the, Contractor's License Law.)
O I am exempt under Sec. 8: 1> P.C. for this reason -
S.M.1. •� �
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
O Copy is filed with the city., O Certified copy is hereby furnished.
TOTAL AA 017, AA
REMARKS'. y y r
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (5100) 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
Ihereby 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 Street Setback from Center Line
Side Setback from Property.Line
Lender's Name
FINAL DATE INSPECTOR '
4/12/88
Lender's Address
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.
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.
Issued by:' Date Permit
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IKITCHEN 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 ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
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.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING ,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FIN�H GRADING
INAL INSPECTION 1
i
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL