002906 (SFD)• P.O. BOX 1504 No. . 002906
Building 78-105 CALLE ESTADO
Address JS"`M11=1 CM49C LA QUINTA, CALIFORNIA 92253
Owner
BUILDING: TYPE CONST. OCC: GRP:,
Mailing
Address 75,M5 tXV ClUb Dri.'Ve A.P. Number
City Palm Zip Tel.
Desert 92260 568-2=Legal.Description
Contractor Project Description PM VaW MASS 15 A
24ti.0 l V=tgacia and LPAW _
Address 1
Z17ty .. _ Zip Tel..
State Lic. City PV` 1330
& Classif.. 288M Lic. # 328 Sq. Ft. M 424 No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer New IX Add ❑ Alter ❑ Repair ❑ ' Demolition ❑.,
Address Tel.
City Zip. State
Lic. #
_ LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I:amdicensed under provisions of,Chapter 9 (commencing with.Section"
7000) of Division 3,of the Business and Professions Code, and my license is in full,force•arid
effect. T,+ ..- ...�.1 �f
i
SIGNATURE` __. 1, l r y DATE
OWNER -BUILDER DECLARATION Estimated Valuation p nA
I hereby affirm that I am exempt from the Contractor's License Law for the followingp231 a �fvi '
reason: (Sec.. 7031.5,Business and Professions Code: Any city or county. which requires a, - '
permit to construct, atter, improve, demolish, or repeir 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 Plan Chk. De
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a .permit p
subjects the applicant to a civil penalty of not more than five hundred dollars ($500J. �RA
O I, as owner of -the. property, or my employees with wages, as their sole compensation, will Plan Chk. Bal. .� .49
'do the wo-rk, and the structure is not intended proffered for sale. (Sec. 7044,'Buisness and Const.' 418.00'*.
Professions Code: The Contractor's License Law does not apply to an owner. of property who
builds oi, improves thereon and who does such work himself or through his own employees,. Meth. �
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
La''
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
--struct -the project. (Seca 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.1.{�1�
such projects with a contractor(s) licensed pursuant to the Contractor's.Ucense Law.)
Grading
❑ 1 am exempt under Sec: B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure 1.933.6-6
WORKERS' COMPENSATION DECLARATION
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
0. Copy is filed with the city. ,q Certified copy is hereby furnished.
_TOTAL 20362.26
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'.'COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation '
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 ZONE: BY:
subject to the Workers' Compensation provisions or 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 Cieriter Line
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 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 FI NAL.DATE INSPECTOR
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. Issued by: Date "" ' 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.,,
mentioned property for inspection, purposes. Validated by:
Signature of applicant /� F ' Dated/
Mailing Address . t J 1 Validation:
City, State, Zip
A -1Z90 2 10 X56226 Cf
HARD COPY
CONSTRUCTION ESTIMATE
` NO. ELECTRICAL Efftl
NO. PLUMBING FEES
IST FL. SO. FT. ®
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT. @
WALL SO. 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
SLAB GRADE 3. .- �,�
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
AS (ROUGH) _
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
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 C
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® 3/ac
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
11 IL SETBACK �' -,
0ROUND PLUMBING3-3-'P?
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3. .- �,�
RCROUGH PLUMB. -�.�_�
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WER OR SEP b • 19
ROUGH WIRING
DUCT WORK
ROCK STORAGE
QUIFOUND.REINF. 3 13 T-/
AS (ROUGH) _
METER LOOP
HEATING (FINAL)
OTHER APP.IEGUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
INAL INSP. _
FRAMING„� !
A` INAL INSP. -.2�G
-1f
gCeROOFIN 2e2CC �/'R / —”REMARKS:
VENTILATION
C? 14 T0 4!!Z�/0
•Ja�*-,Aec
S 4
^-,a 't
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
U49L.ATHING
MESH
INSULATIONISOUND !J =15.��
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
�INSYtIa UR'J SItiNAl UlItSlIN1t1ALS, .
GARDEN WALL FINAL