07277 (SFD)4
P.O. BOX 1504 No. 07277
Building78-105 CALLE ESTADO
Address 78-965.,ftyward Way LA QUINTA, CALIFORNIA 92253
Owner
Starlidt. Dunes Partnership
BUILDING: TYPE CONST. OCC,.'GRP..
Mailing
Address P.O. BOX 329 A.P.,Number
City lZip Tel. Lot 36
La Quint- 1 92253 564-2228 Legal Description Frontier ftdel
Contractor Project Description
Ridt. Johnson Construction
Address
Same
City Zip Tel.:
State Lic. City
& Classif. 397169 8 Lic. # 202 Sq. Ft- 2687 No. No. Dw.
Arch., Engr., Size . - Stories Units
Designer New 0 Add 0 Alter 0 Repair 0 -Demolition 0
Address Tel.
City Zip State
I Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am l6rised under provisions of Chapter 9 (commencing with Section
7 Division 3 of the B6s!ndss.and Professions Code, and my license is in full force and
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following Estimated Valuation
reason: (Sec. 7031.5,Business and Professions Code: Any City Or county which requires a $141,n6
Permit to construct, after, 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 PERMIT AMOUNT
the provisions of the Contractors 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 Plan Chk.,Dep.
subjects the applicant to a civil penalty of not more than rim hundred dollars ($500).
0 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and 9b b -U.
Professions Code: The Contractor's License Law does not apply to an owner of,property who Const.•
builds or=roves thereon arid, who does such work himself or through his own employees, bu ou
provided improvements such impvements are not intended or offered for sale. If, however, the building Mech.
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical
of Proving that he did not build or improve for the purpose of safe.)
0 1, as owner of the property, am exclusively contracting with licensed contractors to con, Plumbing
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 S. M. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
0 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
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
.
0 Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE A
(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 thp 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 ff, after making this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such Provisions or this Permit shall be deemed revoked. Minimum Setback Distances:
Front Setback from Center Lin
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center 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, CIO Code.) Side Setback from Property Line
Lender's Nam
Lender's Address
. This is a building permit when properly filled out, sighed and validated, and Is subject to FINAL DATE -INSPECTOR
expiration it work thereunder is suspended for 180 days. 2/?.8/"
I cer Illy that I have read this application and state that the above information is correct. lssued,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 -Date
Mailing Address Validation:
City_ State,. Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE sly etrOQ
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
/ /
SEWER OR SE TA K L
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH) !ff-p0
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
WALL SO. FT. ®
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ -Plus-X$-=$
URINAL
SO FT ®
FRAMING 27 O LD
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
a
/Vl
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® Vic
HOUSE SEWER
CERT. OCC.
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
SETBACK
- r.? V=7P!: -4
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE sly etrOQ
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
/ /
SEWER OR SE TA K L
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. i y
GAS (ROUGH) !ff-p0
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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. �� -7
FRAMING 27 O LD
FINAL INSP.
/
ROOFING G
a
/Vl
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALLL
T ING
MESH
INSULATIONISOUND 2/304 L
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL