002901 (SFD)AN
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 5"291 Sbml Cmek' . LA QUINTA, CALIFORNIA 92253
Owner
S'im
NO. 002941
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address�qtlb r)rjX0A.P. Number
City JZip ITel.
Contractor
Addres---
saw .--.--
City ITIP
Tel.. .
Legal Description
Project Description TIM WM.W 15 A
P1 AN
State Lic.
' & Classif. 288130
City
Lic. #328
DIM B48
Sq. Ft. M 424
Size -
No. No. Dw.
Stories -Units
Arch., Engr.
Designer
New C.� Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION _
I hereby affirm that=I arr licensed under provisions of Chapter 9 (commencing with Section
7000) of Division,3=61` the Business and,Professigns Code, and my license is in full force and.,
effect..
SIGNATURE DATE
OWNER•BUILDERDECLARATION f
r
I hereby affirm that I am exempt from the 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 of not more than rive hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation,'will.
do the work, and the structure is not intended or offered for sale. (Sec. 704.4, Buisness and
. Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or .through his own employees,
. provided that such improvements_are. not intended or offered for sale.. If, however, the building
or -improvement is sold within one year of completion, the owner -builder wiY have the burden
• of proving that he did not build or improve" for the purpose of sale.) --
• ❑ I, as owner of the property, am exclusively contracting with licensed. contractors to con-
• struct the project. (Sec: 9044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who'contracts for
- such projects with a contractor(s) licensed pursuant to the Contractor's License, Law.)
0 I am exempt under Sec. - B. 8 P.C. for. this reason -
Estimated Valuation
'a Aq
l07flR e •00
sir
PERMIT
-
-
AMOUNT
•r-
Plan Chk:Dep.
-
-
Plan Chk..Bal.
'
370.58
COftst.
A55.50
Mech.:'-34.RA
.
QIP
Electrical"
�P��
Plumbing
,
SZ'� 50
S.M.I.
7�k
Grading
Driveway Enc.
Date Owner
Infrastructure�°$,�g.
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
❑ Copy is filed with the city.. ❑ Certified copy is hereby -fu rnished.
-CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one. hundred dollars (S 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 sous to become subject to the Workers' Compensation
Laws of California.
TOTAL
2.64A.80
REMARKS
-
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.
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.)
Lender's Name
Lender's 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..
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. r /
Signature of applicant �/ f P 1 1 - r Date's '•
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 Z4-97 Permit
Validated by:
Validation:
A%Z9% 2 10 i 6 4 8
CONSTRUCTION ESTIMATE -
NO. ELECTRICAL FE '
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
A.C. UNIT
2ND FL. SQ. FT.
-SLAB GRADE _t 9
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DRAINAGE PIPING
WALL SQ. FT. ®
DUCT WORK
DRINKING FOUNTAIN
SQ. FT. ®
-AS (ROUGH) '_/ f j. I
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
REINF. STEEL 3�—&
FLOOR DRAIN
MECHANICAL FEES
TEMP. POLE
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
AL INSP.. tr�
LAUNDRY TRAY
AIR HANDLING UNIT CFM
WATER SYSTEM
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
REMARKS:
SQ. FT. (off c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/a c
SEWAGE DISPOSAL
FIREPLACE
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAR. FIREWALL
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
��,�fSETBACK ' ./�—
r&(,
�iROUND PLUMBI G
UNDERGROUND
A.C. UNIT
COLL. AREA
-SLAB GRADE _t 9
C&-41OUGH PLUMJ&�_2j'?
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS (�
EWER OR S IV?X11yUGH
WIRIN$/ S G—j
DUCT WORK
ROCK STORAGE
6,E0UND. REINF. y? �e
-AS (ROUGH) '_/ f j. I
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL 3�—&
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
AL INSP.. tr�
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$ $
LUMBER GR.
AL INSP.
(:o-QY- /
nff�RAMING /�
Al_ INSP.�
,6-e M
^
IDQ /C/
h - !A C' D
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
6,4a-ATHING <_—
MESH
INSULATION/SOUND 5 L�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL -
I V N'S b1UNA1 V XtW1Nl1IALS
GARDEN WALL FINAL