07274 (SFD)4
P.O. BOX 1504 No.
Building 78-105 CALLE ESTADO
Address 43-695 SkVlard Wily LA QUINTA, CALIFORNIA 92253
Sta ri f qht Dunes Partners
Address P. Q. BOX 329
City Zip Tel.
. . .. a Quinta .92253 564-2228
Contractor
. Rich{ Johnson coattruction,
Address
Same
City Zip I Tel.
State Lic.. City
& Classif. %� 6Lic- # 202
Arch., Engr-,
Designer •
Address Tel.
City (Zip (State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
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 force and
• effect
SIGNATURE - DATE
OWNEWBUILDER DECLARATION
I hereby affirm that 1 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
pemrit to construct, altar, improve, demolish, or repair any structure, prior to its issuance also
regimes the applicant for such permit to Me a signed statement that he is licensed pursuant to
.the Provisions of Ore Contractor's license Law, Chapter 9 (commenckhg with Section 7000) of
Llvislon 3 of Ore Busmess and Professions Code, or that. he is exempt therefrom and the basis
for Ore alleged exemption. Any violation of Section 7031.5 DY 'any applicant for a permit
sus the applicant to a civil penalty of not more than rive hundred dol4rs ($500).
• ❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. /Sec. 7044, Buisness and
Pro/essions Code: The Contractor's License Law does not apply to an owner o/ property who
buu7ds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. f/, however, the building
or kmprovement is said within one year of completion; the own will have the burden
of proving Mat he did not build or oWrove for the purpose o/ sale.) -
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it Me permit is for one hundred dollars ($ 100) valuation
or fess.)
I certify that in the performance of the work for which this permit is issued, I shall not
employ -yi=n in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
N077CE TO APPLICANT: N, 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 pertofinance of the
work for which this permit is issued. (Sec. 3097, Ciel Code.)
Lenders Name
Lenders 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 car that I have read this application and state that the above information is correct
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
City,- State, Zip
LDING: TYPE CONST. OCC: GRP.
P. ,Number
Legal Description Lot 22
Project Description Frontier Mode?
Sq. Ft. 2687 No.
Size Stories
07274
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑
'Demolition ❑
Estimated Valuation
$14Ts266
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
4 .645.90
Const.
786, big
Mech.
60.01) '
Electrical
136.96
Plumbing
144.50
S.M.I.
9..39
Grading
Driveway Enc.
Infrastructurer%.
TOTALEyi.t3
REMARKS
W,.: s.. -ACK I I'tf'f f4L
2 ItY61 , i
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
2/28/90
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. SO. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF� L />
G i�
MOBILEHOME SVC.
BAR SINK
POR. Sp. FT. ®
REINF. STEEL
01 GAS (FINAL) 4s 4s TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. Sp. FT. ®
LUMBER GR.
FINAL INSP.
FRAMING Walk,G
FINAL INSP.
DRINKING FOUNTAIN.
WALL SO. FT. ®
REMARKS:
URINAL
Sp. FT. @
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
MESH
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.
SO. FT. ®c
BATH TUB
CERT. OCC.
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
Sp. FT. RESID ® 11/a c
SEWAGE DISPOSAL
INSPECTOR'S SIGNATURESIINRIALS
SO.FT.GAR ® 3/ic
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE __jCONST.
FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �I�
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SEPTIC TANK—?/ WIRING
L�METER
DUCT WORK
ROCK STORAGE
FOUND. REINF� L />
G i�
AS (ROUGH)/f , 9a LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
01 GAS (FINAL) 4s 4s TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING Walk,G
FINAL INSP.
ROOFING
wa/A
ID 4,0.fI t (SC [ Y
Ce)
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACETL
SPARK ARRESTOR
GAR. FIREWALL
LA I G to fl L�
MESH
INSULATIONISOUNDB 20 o
v
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINRIALS
GARDEN WALL FINAL
I