06182 (SFD)T4ht 4 4 Q"
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 78-9.25 Skyward Way LA QUINTA, CALIFORNIA 92253
Address?. 0. 3U.X 329
City Zip
La Quints 922563
Contractor
Rick 3Qhnaou Construction
Address
Zip
. _564.2223
State Lic. City
& Classif. 397169 Lic. # 202
Arch., Engr.,
Designer
Address Tel.
City ( Zip ( State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 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 lei , y-.: G ` tat i
_SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm than 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. after, 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
the provisions o1 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 exerrption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a crvg penalty of not more than rive hundred dollars ($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
Professions Code: The Contractors License Law does not apply to an 'owner of property who
builds or irproves thereon and who does such work himself or through his own employees,
provided that such.nprovements are not intended or offered for sale. It, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or inprove for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to coir
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.)
❑ 1 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 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.
Date Owner
NOTICE TO APPLICANT: H, after making this Certificate of Exemption you should become
subject to theftrkers' 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.).
Lenders 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 property for inspection purposes.
Signature of applicant -Date-
Mail in
ateMailing Address
City, State, zip
No. 06182
BUILDING: TYPE CONST.• OCC: GRP.-
A.P. Number Tract A773
Legal Description
Project Description Lot 40, Hodel FR Fm tier
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Sq. Ft. 2525
Size -
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolitio- ❑
FINAL DATEINSPE
TOR
t�89
Issued by:
Date Permit -
Validated by:
Validation:
Estimated Valuation
$133,364
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
.
Const.
758--.50
Mech.
.O
Electrical
136.96
Plumbing
144.50
S.M.I.
9.38
Grading
Driveway Enc.
Infrastructure
3,400.6,0
TOTAL
$4,737.15
REMARKS
4.1.WZ�i�'A ��k,•r�Rlsw�.7•.xz > � i
:;x'i .r :.e E,.,. ., . , , « ..- .,
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 DATEINSPE
TOR
t�89
Issued by:
Date Permit -
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
SLAB GRADE �� -Zv
OUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
FORMS
SEWER OR SE C ANK ®
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
AS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. @
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN
WALL SQ. FT. ®
=S
LUMBER GR.
FINAL INSP.
FRAMING y 7�
URINAL
SQ FT ®
`
/�O ...moi �
(� `( /•L`�L
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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(AUTOXDISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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
FINISH GRADING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/4c
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 PLUM= V ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBINGUNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �� -Zv
OUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE C ANK ®
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
AS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
j -plus-x$
=S
LUMBER GR.
FINAL INSP.
FRAMING y 7�
FINAL INSP.
ROOFING �Z '��/ � .G
`
/�O ...moi �
(� `( /•L`�L
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I