003391 (RPL)44
P.O.. BOX 1504 N'o• 003391
Building ae•�-ari0o 78-105 CALLE ESTADO
Address 48-143 Ca11 a `Serrano LA QUINTA, CALIFORNIA 92253
Owner _.
....
�ef7lliirr #t15flt BUILDING:" TYPE CONST. • OCC:.GRP.
Mailing
Address C mom" A.P. Number Lacuna -De La Pax
City - • zip .- .. -Tel:
La. -Qu i nta.d... .,€.x.2253... Legal Description
Contractor .
. Pro'ect Description- SP,a +� P�fa,l
A & W1 20e1 P1 umbli ne A11 Amer' ica Poo . sl
Address
73-725 E. _hseo #2_30
CityZip Tel.'
Palsy Desert 32260 340-3447
State Lic. City
& Classif: • 404640 Lic. # Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.; ,
Designer New. ❑ Add ❑ Alter ❑• Repair ❑ Demolition ❑
Address Tel.
City Zip State
_ Lic..#
LICENSED CONTRACTOR'S DECLARATION
1. 1 hereby affirm that I am licensed under Provisions of Chapter9 (commencing with Section
•, 7000) of Division 3 of the E16siness and Profession!Code-I Oy=lI mme is in full force and '
effect... .. �
OWNER -BUILDER DE ARATION i
Estimated Valuation p
I hereby affirm that I am exempt from the Contractor's License Law/or 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 -PERMIT - --AMOUNT -
• the provisions of the Contractor's License Law, Chapter 9 (commencing with. Section 7000) of -
Division 3 of fhe 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'live. hundred dollars ($500): "
aa
❑ I, as owner of the property, or my employees with wages as their sole compensation, willPlan Chk. Bal.
, :
do the work, and the structure"is not intended or offered.for sale. (Seca -7044, Buisness and
Professions Code: The Contractor's* License Law does, not apply to an 'owner of property who COr1St.'..,
builds or improves thereon and 'who does such work himself or through his- own employees, Mech.' '
. 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 . Electrical - ',�
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 y�
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 $• M• I •such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑.I am exempt under Sec. B. & PZ. -for this reason
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 certif ied copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
Copy is filed with the.city. _ ❑ Certified copy.is hereby furnished.
TOTAL �a i
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.). .. ...
.I certify that in the performance of the work for which this permit is issued, I shall not (VARA 0ins A - ty`< (1. —I)i rats In
-employ any person in any -manner so as to become subject to the Workers'- Compensation -
Laws of California. -)-e'E7'nl t it tL• +�• �'t�
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 Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.' - -
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 aboveinformation is correct. Issued by: Date / 2 1 /87Permit
I agree to comply with all city and -county ordinances and state 'laws relating to building - '
construction, and hereby authorize representatives iof 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 -
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CARP. SQ. FT.
WALL SQ. 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
PLUMB/6-
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
C
FINAL INSP.
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�$OUGH
PLUMB/6-
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
C
FINAL INSP.
ROOFING
12
%/17
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
t: