13122 (SFD)44 P.O. BOX 1504 Vim/
Building 79..750 T833Ljel0LA QUINOTACCAL CALIALLE FDO
ORNIA 92253
Address
J.I. Peters Co., Inc.
Mailing
Address 3501 Jamboree toad, #200
City Zip Tel.
Newport Beach, CA 926601(714)854-2500
Contractor
Same
Address
Tel.
State Lic.310868 B (City
&1503
Classif. Lic. #
Arch., Engr.,
Designer Serkus Group
Address Tel.
26 Corporate Park (714)261-8262
City Zip State
Irvine, CA 1 92714 Lic. # C 6885
LICENSED CONTRACTOR'S DECLARATION
VI hereb affirm that I am licensed and r provisions of Chapter 9 (commencing with Section
7000) of 'vis on 3 of the Busin::; d PiOfessions Code an my llejfec icer/Ise is in full foplce and
111 SIGNATURE `l DATE
OWNER -BUILDER DECLARATION
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, after, improve, demolish, or repair any structure, prior :o 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 five 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 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 will 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. 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
Worker' Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
POI E o. .Company
❑ 6
opy 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: 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 it work thereunder is suspended for 180 days.
I cerr)',y that I have read this application and state that the above information is correct.
I agr,, to comply with all city and county ordinances and state laws relating to building
const.Mction, and hereby authorize representatives of this city to enter the above-
mentioned property for inspection purposes.
Si```ature of applicant Date
Mailing Address
City, State, Zip
No. 13122
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number 769-550`002
Legal Description Lot 2 Tract 24890-3 Phase 1
Project Description SFn Plan 4
Sq. Ft. 3710 No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair 0 Demolitio=l ❑
Permit does not include any block walls
or pool.
stimated Valuation
$288+273.00
PERMIT
AMOUNT .
Plan Chk. Dep.
Plan Chk. Bal.
+05U. 17U
Const.
.1+.JU •UU
Mech.
f fir_
AA
z.50
Electrical
v
1004. 91
Plumbing;
^, f
04 . UU
S.M.I.
✓
2f3.90
Grading
��1
ZU.OU
Driveway Enc.
t
—0—
Infrastructure
b s U
>wS in FUMVI C r acct;
410.0-8
TOTAL
9,390.15
REMARKS
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
C C ►" ►'
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
I
WALL SQ. FT.
WATER SYSTEM
DRINKING' FOUNTAIN.
GRADING
cu. yd.
$ plus x$
=$
URINAL-.
SO. FT.® '
FRAMING
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuatlor
REMARKS:
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
LAUNDRYTRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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
INSULATIONISOUND
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT; B-.T.U. ' "
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
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 PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GR O NO PLUMB I
UNDERGROUND
A.C. UNIT
COLL, AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
66 EINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
A
CITY OF LA OUINTA
irT 69WATMENT OF PLANNING & DEVELOPMENT
k.
BUILDING DIVISION
i r'* t ; a 564-2246
? 4 HOUR NOTICE FOR INSPECTIONS
lig `I.•'��N.���� ' ;
FMANU. ArAn •
o+ '-
Owner �J.,-
M"'Peters Co. , Inc.
Con6dor S ame -
Pan it Numbo�r:� It`l'312 2
OST ON JOB IN CONSPICUOUS PLACE
INSPECTOR 'MUST SIGN ALL APPLICABLE SPACES
79-750 TangeloMAM 4C
J08 /1D D KESS; ^'��-
S F I Permit!-'.'doe's not include any block
walls'or pool.
TYPE OF,'INSPECTION . DATE INSP.
FOUNDATION 8 SETBACK
FOOTING STEEL':;:,'.:
MAIN GROUND SYSTEM.
..
GROUND PLUMBING s �.
RE-GUNITE. ,-
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB • .. 3
JOISTS 8 GIRDERS.
ELECTRICAL GR28he. WORK
O NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING.
UGH GAS & GAS TEST
EATING 8 VENT"-A/C
FIREPLACE
FE ;tii �i•.;
,f, r,a . .
BOND BEAM ,:`•';"
$O.K:,TO WRAP'.'
GROUT O 4' il!0`8'
FRAMING 'i;
INSULATIONkz- L_G
( zz
PRE'ROOF "'
OVER NO'WORK UNTIL ABOVE HAS BEEN SIGNS
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL` FENCE 8 GATE .
SEWER SEPTIC TANK Q -12 - 3
FINALS
ELECTRICALC— (,
PLUMBING
FINAL GAS TEST,
HEATING - A/C
OUSE NUMBERS
JOBCOMPLETED _
IFTfEmp POWER `ii:'
l., ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
"L' TURN ON UTILITIES OR OCCUPY BUILDING
i.;
4/88'1(:.. •`r' F {;' 11
A
is'
P.O. BOX 1504 APPLICATION. ONLY
Buildingr..��� A /`�L 7&105 CALLE ESTADO
Address tJ c- LA QUINTA, CALIFORNIA 92253
Owner
Mailing / BUILDING: TYPE CONST. OCC. GRP.
Address 1
3S
A.P. Number
City n Zip Tel. t, / l(
��/C�Gt.Pc�R7 JSC �Zb 714 WI ZS�� Legal DescriptionIX ?_ggcro_� w� 1 Z'"
Contract M nRt s Project Description
Address / " 'a
City Zip Tel.
State Lic.�j City
& Classif. ?j �O �j �� Lic. # Sq. Ft. ?� f No. No. Dw.
Arch�Engr.,�A ) / Size > is Stories Units l
Designer /�7�e� (�✓�j �jV New,7 Add ❑ Alter ❑ Repair ❑ Demolitirn ❑
AddZ�sS�Q A__
�- I�l� 26/
,,Ci.ty Zip State
�f�-#'%jN �Z„ 7! Y Lic. #
f • .LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am Iitj�d under provisions of Chapter 9 (commencing with Section
7000) of Divi n of he Busi ess and Professions Code, and my license 1's in fuI .force and
effect. /�✓ Z
S GNATUR 111 l'D�ATE _
OWNER -BUILDER DECLARATION `
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
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 file a signed statement that he is licensed pursuant to PERMIT AMOUNT
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 Plan Chk. Dep. s�` C
subjects the applicant to a civil penalty or not more than five hundred dollars ($500).
l] I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structures not intended or offered for sale. (Sec. 7044, Buisness and (,Oust.
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself or through his own employees, Mech.
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical
of proving that he did not build or improve for the purpose of sale.)
I 1 I, asowner of the property, am exclusively contracting with licensed contractors to con- Plumbing
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improv9s thereon, and who contracts for S. M.1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
I'] I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
�W✓orker's Com ensatioA I$ surance, or a ce tied opy t er�eof (Sec. 3800 Labor Code%
-Policy No.r4 Z G i Company �„ A �'I j••- ��1d
0 Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL :S
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less. J
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. 01()51- 1,0 399A_Qf-Q5-9A,_,,, 10
Date Owner 1 V t A.f tt 1 I U I HI.. Y d._ V. v'u
NOTICE TO APPLICANT: If, 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 Line
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, Civil Code.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
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. Issued 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 tc enter the above-
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
BUILDING DIVISION
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
•
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. $
UNITS
HEATING (ROUGH)
2ND FL. SO. FT. @
FORMS
YARD SPKLR SYSTEM '
POR. SO. FT. @
MOBILEHOME SVC.
BAR SINK
GAR. SQ, FT,
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
OTHER APPJEQUIP.
DRAINAGE PIPING
WALL SO. FT. @
TEMP. POLE
DRINKING FOUNTAIN
SO. FT. @
GROUT
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
WATER SYSTEM
FLOOR DRAIN
MECHANICAL FEES
_$
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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'A c
SEWAGE DISPOSAL
LATHING
SO.FT.GAR @ ?4c
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
INSULATIONISOUND
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (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.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL