002907 (SFD)P.O. BOX 1504 N O : 002907
Building 78-105 CALLE ESTADO
Address 55-113 Sboal QW& LA QUINTA, CALIFORNIA 92253
Owner
BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address ']$' 005 Cmmtry Club- Drive A.P. Number
CityZip Tel.
palm- 92M S6813-2828 Legal Description
Contractor. is�'s SSE
.. Mtfxz . !�5 and Project Description
Address
City. Zip . Tel:
aa+�sc
State Lic. City
& Classif. 288130 Lic. # 32$ Sq. Ft: 1330. No. No. Dw.
Arch.; fngr:, ... -
Size 424 Stories Unit&
Designer New Ok Add ❑ Alter ❑ Repair ❑• Demolitioru ❑
Address Tel.
City Zip State
_ . Lic. # .
LICENSED CONTRACTOR'S DECLARgTIQN
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 foice and
effect.
SIGNATURE "'" _r -- ✓' f DATE _
OWNER:BUILDER DECLARATION %
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation 94.-244.00'
reason: (Sec.. 7031.5,Businass and Professions Code: Any city. or county which requires a, S'
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 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 Plan Chk. -D.ep.. -
subjects the applicant'to a civil penalty of not more than five hundred dollars ($500)- a �y
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. ►
do the work, and the structure is not intended -or offered. for sale. (Sec. '7044, Buisness'and Const.
Professions Code: The Contractor's License Law does. not apply to an owner. of property who 418.00 .
- builds or improves thereon and who does such work himself or through his own employees,- O AD
provided that' such improvements are not intended or offered for sale. If, however, 3 -the building Mech. Vti
or improvement is sold within one year of completion, the owner -builder will have the -burden Electrical 59.99
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 87.50
struck 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 S.M.I. 6'.62
such projects -with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
O I am exempt under Sec.. B. & P.C. for this reason
Driveway Enc. CC£1
Date ' Owner Infrastructure Ir413.66
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. ' Aompany -
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL 2,362.26
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation -
orfess.) _.._-
, 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 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'Llne
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. � l
I certify that I have read this application and state that.the above information is correct. Issued by: Date 6—Permit
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- 0'
mentioned property for inspection purposes. . ,
y ..- n Validated by:
Signature of applicant. r r Date—.
Mailing Address I Validation:
City, State, Zip /
A7289 2 lU 26226 Ct,
HARD COPY
CONSTRUCTION ESTIMATE
NO.. ELECTRICAL EB@lo&
NO. PLUMBING FEES
1ST FL. SO. FT. ®
2ND FL. SD. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CARP. SQ. FT.
WALL SQ. FT.
SQ. 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
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
/,�
V
LAUNDRY TRAY
AIR HANDLING UNIT CFM
ROCKSTORAGE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SERVICE
SQ.FT.GAR @ 3/ac
HOUSE SEWER
FINAL INSP.
BOND BEAM
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
7/ /SETBACK �
ROUND PLUMBING .:Z- &q
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ,moo -99jjaOUGH
PLUMB. C'?
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
jj4eSEWER OR SEPT T Q-?
TROUGH WIRING
/,�
V
DUCT WORK
ROCKSTORAGE
FOUND. REINF. ! �'
AS (ROUGH) C
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
A
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
INAL INSP. _? ��
2(,,/FRAMING �3
INAL INSP. ^Q�
% ROOFING ^� -'/—.Z 2—T,?
T- 0 G.t/
10A / w4eC-
�� ,y' �/
f 7 ��/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
)bJ LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL