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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