06431 (SFD)4
P.O. BOX 1504 No.
Building ' • 78-105 CALLE ESTADO
Address 54-648 Shoal Creek LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address _AAQ4 AWM
City Zip Tel.
Palo Dese'r.t. 92260 _ *—Z823.
.
tioml Lahti
Address .
ty
Zip
State Lic. I City
& Classif. 268130 Lic. # 328
Arch., Engr.,
Designer
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I heretiy affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Divisioxn 3 ��
of the Bus}ines .and Professions Code, andmy license is/in full (force and
Y.r. J~ r 7i1 A.• w .f,
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 Pmlessions Code::'Any city or county which requires a
permft to construct, after, improve, demorsh, or repair any structure, prior to its issuance also
requires the applicant for such permit to We 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 the Business and Professions Cade, 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 cin? penalty of not more than rive hundred dollars ($500).
❑ 1, 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
Winds or improves thereon and who does such work himself or through his own employees,
provided that'such improvements are not intended or.oftered for sale. If, however, the building
or improvement is sold within one year or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of safe.)
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this teason
Date Owner
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 fumished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE'
(This section need not be completed if the permit is for one hundred dollars (8100) 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: ff. after making this Certificate of Exemption you should become
sub%ect to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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.)
Lenders Name--
Lenders
ame
Lenders Address
This is a building permit when property filled out,.signed and validated, and is subject .to
expiration if work thereunder is suspended for 180 days.
I certity 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
City, State, Zip
BUILDING: TYPE CONST. OCC: GRP..
A.P. Number PGA West — Phase 1ST'
,7- f
06431
Legal Description
`Pratt 20017-3, Plan 4M
Project Description
Sq. Ft. 1$1i No. No: Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolitk)n ❑
Estimated Valuation .$132,816
PERMIT
BY:
AMOUNT
Plan Chk. Dep.
Front Setback from Center Line
Plan Chk. Bal.
56402,6
Const.
Side Setback from Property Line
755.00
Mech.
INSPECTOR
MAO
Electrical
Issued by:
112.04
Plumbing
131.(}0.
S.M.I.
Validation:
9.31 �..
Grading
Driveway Enc.
Infrastructure
$2,988.36
1,49 4.18
Less Credit
1,494.18
TOTAL
$3,116.79
r' t
REMARKS
lnirlt li � a 4 fi "5 0 7=
fl %r��f4
ftl3air, i a.X1J,:7
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
/28/89
Issued by:
—Date—Permit—
DatePermitValidated
Validatedby:
Validation:
l
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
A.C. UNIT
COLL. AREA
RADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
BONDING
HEATING (ROUGH)
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
ER OR SEP4 T
ROUGH WIRING
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
A. (ROUGH)
METER LOOP
DRAINAGE PIPING
CARP. SQ. FT. ®
. STE L10
GAS (FINAL)
DRINKING FOUNTAIN.
WALL SQ. FT.
ROUT
WATER HEATER
URINAL
SQ. FT.
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
LUMBER GR.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
OOFING, �-
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
d"�1 �L•��C
���� ��`'���t'
�� /l
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SPARK ARRESTOR
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LATHING
SO.FT.GAR ® V4c
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/
?4
UNDERGROUND
A.C. UNIT
COLL. AREA
RADE
RO GH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR SEP4 T
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FO REINF. r
A. (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
. STE L10
GAS (FINAL)
TEMP. POLE
ROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
�INAL INS / ��
1�FRAMING _
FINAL INSP.
OOFING, �-
�/
/r' o
Ole'
v✓` l^���
'
d"�1 �L•��C
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REMARKS:
or VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND Z_
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
1