06062 (CP)4 _
P.O. BOX 1504 N o . x 4-06062
Building 78-105 CALLE ESTADO
Address 54--707 Shoal Creek LA QUINTA,,,CALIFORNIA 92253
Owner
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 42-600 Cook St. _ A.P. Number FCI!k bleat
City Zip Tel. _
Palm Desert 92260 55$-2828 Legal Description
Contractor
Gni Fobs. Construction
Address .
68-465 Perez Rd.
Cat City IZfp 32234 I'l-328--2681
State Lic. City
& Classif. C.53-275796 Lic. # 59
Arch., Engr.,
Designer
Address Tel.
City,Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I arrl-Iicensed under provisions oYCAapter 9 (commencing with Section
70pp) of Division 3•ofthe"Business'and Profess ; ai
ions;Coderd•my license is in full force and
effect. �� _��, • :r'^�+ .-•3'" , �f '----�`� 'i ` � ".: y'�
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
'reason: (Sec. 7031.5,8usiness and Professions Code: Any cRy of county which requires a
permit to construct, after, improve, demofsh, or repair any structure, prior to its issuance also
requires the applicant tor.such permit to fie a.signed statement that he is licensed pursuant to
the provisions of the Contractors 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 civi 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
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The Contractors License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not "extended or offered for sale. ll, however, the building
or improvement is sold within one year of completion, the owner-bufider will have the burden
of proving that he did not buid or improve for the purpose of sale.)
❑ 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 bums 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 reason
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 certified1copy thdir6cf. (Sec. 3800, Labor Code.)
Policy No. Company ' .
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the pemxif 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
=any person in any manner so as to become subject to the Workers' Compensation
Laws of California
Date -L --Owner
NOTICE TO APPLICANT. 8, 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 of flus permit shag 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, Cfvd Code.)
Lenders Name
Lenders 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.
1 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
Project Description
Pool- and s$3
Sq. Ft. No. No. Dw.
Size ... Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation 20,Cfl0.00
PERMIT
AMOUNT
Plan Chk. Dep.
Distances:
Plan Chk. Bal.
134.55
Const.
207.-0 .
Mech.
27..00
Electrical
30.30
Plumbing
24.00
S.M.I.
1.40
Grading
Issued by:
Driveway Enc.
Validated by:
Infrastructure
Validation:
TOTAL , .:� .'ra atx e s
REMARKS <.� .e 4.Vrt .i/+� t x'v �f 11�
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
7-5-89
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
INF. STEEL
AS (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN
WALL SQ. FT. @
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SQ FT ®
GRADING
cu. yd.
plus x$
-$
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFING
FLOOR DRAIN
MECHANICAL FEES
I
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ec
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE 7ONST.
FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE . PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACKD
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.
G (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
INF. STEEL
AS (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
—'P11101 GRADING
AL INSPECTION (O
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL