002887 (SFD)Building
Address 55'125
Owner
I
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No.
Mailing
Address ,� C` 14%+ v4k
BUILDING: TYPE CONST.
A.P. Number
Legal Description.
Project Description
OCC:'GRP:
NA VIM PBAM 14 'c1
City Zip
..Pzam 92250 ,
Tel.
568-2828
Contractor
Address
Aliam
Side Street Setback from Center Line
City. _
sama
Zip
Tel.._
FINAL DATE
INSPECTOR
State Lic.
& Classif.
?x4€3231'
City
Lic. #
?2$
1330-
Sq. Ft.
Sizer_"_CM'. 4,24
No. No. Dw:
Stories Units
Arch.; Engr:;
Designer
New ffft Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
2 b 236226 CK
City
Zip
State
Lic. # -
LICENSED CONTR&CTOR'S DECLARATION,.
I hereby affirm that l am licensed under provisions of Chapter 9 (commencing with Section
70 130) of Division 3-6f the Business and Professions Code, and my license is Infull force and
.effect. r' r . f . �• �. �� ifs
-
SIGNATURE - - - i ! :DATE
- OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from tfle Contractor's License Law for the following.
reason: (Sec. ,7031.5,Business and Professions Code: Any city or county. which requires a
permit to construct, alter, improve, demolish, or repair any structure,. prior to its. issuance also
requires the applicant for•such permit to rile 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 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 civil penalty or not more than five hundred dollars (5500).
❑ 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 Contractor's License Law does not apply to an'owner of property who
builds or improves thereon and wAo 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 wflPhave the burden
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- •
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.) -
O I am exempt under Sec. - B. & P.C. for this reason
Estimated Valuation
94,r244.0,0
�. 'PERMIT
AMOUNT
Plan Chk..Dep..
••
Plan Chk. Bal.
- 342.49
Const.
_
w 00
Mech. -
- 00
Electrical
a wj�{,�
Plumbing
-87.50
S.M.I.
6.62
Grading
Driveway Enc.
Date Owner
Infrastructure
1,43.3.66
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. Company
0 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 permit is for one hundred dollars ($100) 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.
TOTAL
2,362.26
REMARKS
-
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or 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 i construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a 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 properly.for inspection purposes: i
Signature of applicant f ' P'..i Date
Mailing Address ? /
City, State, Zip
HARD COPY
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
Issued by:
Date .2-4-87 Permit
Validated by:
Validation:
A7263
2 b 236226 CK
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FE '
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT, ®
CAR P. SQ. FT.
WALL SQ. 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 �,,,�' '�
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
OUGH WIRING(/,- —�
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
IKITCHEN 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
WATER SYSTEM
SQ.FT.GAR ® 3/ac
HOUSE SEWER
$
GRADING.
cu. yd. '
plus x$
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
?(AC SETBACK —11-'?'7JGD
PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �,,,�' '�
PLUMB ,a I
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS ti ? .
OR SE
OUGH WIRING(/,- —�
DUCT WORK
ROCK STORAGE
REINF., �OUGH)
$� n
/
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
�FOUND.
CL`+1REINF. STEEL .-5-,�`
V
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
otga,
NAL INSP. —/
BOND BEAM
WATER SYSTEM
$
GRADING.
cu. yd. '
plus x$
_$
LUMBER GR.
INAL INSP. 6 ��
&46RAMING L ���
A INAL INSP.
'ROOFINGoj�-c,e L/—% %
6X TV (ticQ� Q "l �i "Qi /� �G
to ��1 WI.Q Lt; I�� `� - l ���1 19A(/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
/pJ��
&&LATHING L dZ 9'� 7
MESH
INSULATIONISOUNDC
FINISH GRADING
%,4FINAL INSPECTION 6,-</. ?7
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL