003050 (RPL)55-09.1 SRM. C e# -.k
WWI
Zip
Tel
Zip _ .. " Tel.
P.O. BOX 1504 No..
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP:-
A.P. Number PGA West
Legal Description
Project Description Phase 15A Pool Pence 300 1.. F.
and 434 L.F. Phase W&lls
City
Lic. # Sq --Fl. x No. No. Dw.
Size 73A ' L. F' Stories Units
New O� Add ET Alter 0- _. Repair 0 Demolitioi.0'
Tel.
Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION V
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with' Section
7000yof Division 3 of the Business and Professions Code„ and my license is in full force and '
effect. ii 4/
SIGNATUREk f °" -- i'! .,C•.r'; r1'.f. -_+ �t� •F'8'..c::+"�-:i.. E ' " :Y / ,F i DATE
` �OWNER•BUILDER DECLARATION
�
I Hee reby affirm that I am exempt from the Contractors License Law for the following.
reason: (Sec. 7031. S,Businass and Professions ,.Code: Any city or, county which requires a �
peimit to construct, after, 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 _
Estimated Valuation
$1$ 350.00 '
.
-
PERMIT NT
AMOU
the provisions of the Contractor's License Law, ,Chapter 9 (commencing with. Section 7000) of
Division 3 of the Busines's`and Professions Code, or that. he. is exempt therefrorri,' 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 of not more than five hundred"dollars ($500). '.
f] JIas owner of the property, or my. employees with wages as their sole, compensation, wily
do the work, and the structure is not intended or offered for sale. (Sec. i044, Bulsness and
Professions Code: The Contractor's 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 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
of proving that, he did not build.or Improve for the purpose of sale.) .
..
Plan Chk. Dep. ..
- • .
Plan Chk. Bal. 3207.4Z
CpnSt... '. 134.50
.
Meth'.
EIQCtrICdl
Plumbing
0 I, as owner of the property, am exclusively contracting with.licensed contractors to con-
slruct 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.)
❑ I am exempt under Sec. B. ti. P.C. for -this reason
-'
_..
S.M.I. 1.30 '
Grading
Driveway Enc.
Date 41- f`a -!owner% -. f`..�rs,'.- ..----.---+�'
Infrastructure
WORKERS' COMPENSATION DECLARATION
I' hereby 'affirm that I.have a certificate of consent to self- insure; 'or acertificate of
Worker's Compensation Insurance, or a certified copy thereof: (Sec. 3800, Labor Code.)
Policy No. Company /-
O..Copy is filed with the city. 0. Certified copy -is -hereby furnished.
TOTAL $223+22
CERTIFICATE OF EXEMPTION FROM
WORKERS'.COMPENSATION INSURANCE
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.
'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
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 Street Setback from Center Line
$Ids Setback from Property Line
Lender's Name
FINAL DATE INSPECTOR "
`��
Issued by: / Date Permit
Validated by:
Lender's Address
' This isa building permit when properly filled out, signed and validated, and is subject to
expiration it 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.
Signature of applicant Date
Mailing Address.
Validation:
E7746 4 14 2222 fl
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. (1 $
UNITS
SLAB GRADE
2ND FL. SO. 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.IEOUIP.
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT . WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
I
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
I 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 GOND. 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.IEOUIP.
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
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL .
INSPECTOR'S WUNAI UHESIINITIALS
GARDEN WALL FINAL