13512 (SFD)r.
TWY�
t
P.O: BOX 1504
Building 78-105 CALLE ESTADO
Address 79-765 Tanezelo LA QUINTA, CALIFORNIA 92253
J.M. Peters Co. t 1
Mailin
Address 3501 Jamboree Road
City Zip Tel.
. Newport Bead, CA 9265 (714)954-7250
Contractor
Same
Address
ty jZip j Tel.
State Lic. B-1. 310€ 68 I City 1503
& Classif. Lic. #
Designer Berkus Group
Designer
Add & Corporate Way Tel. (714) 261-82
City Zip State
Ir:Vina, CA 1 92714 Lic. # C6885
LICENSED CONTRACTOR'S DECLARATION
I herebyq)affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) off Division 3 of the .Business and Professiiions Code, and my license is in fulls force and
Seffect. f4' C.R.L � % N_ L_ I -,' r j - I tt - -f q
IGNATURES - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Lawfor the following
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 Lcensed 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).
O 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, Suisness 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 tis 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 contractors) licensed pursuant to the Contractor's License Law.)
O 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's Compensation Insurance, or a certified copy thereof. (Sec. 3800. Labor Code.)
Policy Nom Company
I1/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 the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of the 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 if 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
Mailing Address
City, State, Zip
No.
BUILDING: TYPE CONST. � OCC: GRP,
A.P. Number 769-560--025
13512
R3
JLegal Description Lot 25 Tract 24890-3
Project Description SFD Plan I
Citrus
Sq. Ft. No. No. Dw.
Size . 3069 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolitio-1 ❑
Estimated Valuation $241,445.00
PERMIT
AMOUNT
Plan Chk. Dep.
r "-,
Plan Chk. Bal.
923.41
Const.
1,136.50
Mech.
96.00
Electrical
182.22
Plumbing
165.00
.S.M.I.
24.20
Grading
20.00
Driveway Eno
00
Infrastructure
51346.34
Arts in Public Places
353.61
4
TOTAL
REMARKS
P ,lit
t
4A 4 14 1
r "-,
A7 V/ ( )
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
4
Validated by:
Validation:
x
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES M
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
�y
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR SO 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.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SO. FT.
=$
LUMBER GR.
FINAL INSP.
URINAL
SO. FT. @
ROOFING
ESTIMATED CONSTRUCTION VALUATION $
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
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
SO.FT.GAR ® V4c
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
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 APPJEOUIP.
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 SIGNATURES/INITIALS
GARDEN WALL FINAL
a CITY OF LA OUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
24-HOUR NOTICE FOR INSPECTIONS
777-7153
CITY 01' LA NOW.
Owner J.M. Peters Co.
Contractor Same
Permit Number 13 512
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
"ADDRESS 79-765 Tangelo
j
SFD 'Lot 25
TYPE OF INSPECTION DATE INSP. j
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE {
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB 6!"/AIX-
JOISTS �.
& GIRDERS, i
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING i
ROUGH GAS & GAS TEST , S
HEATING & VENT • A/C I
FIREPLACE
I
ROOF ,) �. y
BOND BEAM
O:K. TO WRAP
GROUT ❑ 4' ❑ 8' j
FRAMING - l
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR. -
EXTERIOR LATH
POOL PRE PLASTER j
POOL FENCE & GATE i
SEWER SEPTIC TANK i cam_
FINAL GAS TEST
HEATING - A/C
HOUSE NUMBERS
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO '
TURN ON UTILITIES OR OCCUPY BUILDING
4!86
• I