13120 (SFD)12
P.O. BOX 1504 No. 13 0
Building 78-105 CALLE ESTADO
Address 79-770 Tangelo LA QUINTA, CALIFORNIA 92253
Owner
J.M. Peters Co., Inc. BUILDING: TYPE CONST.
Mailin
Address 3501 Jamboree Road, #200 769-590--004
A.P. Number
OCC: GRP.
CityZip Le.Lot 4 Tract 24890-3 Phase 1
Newport Beach CA 3.266014 854--2500 Legal Description
ContractorSFA Plan 2
Same Description
Address
Zip I Tel.
State Lic. 310868 B(City 1503
& Classif. Lic. #
Desi nergr
9 Berkus Croup
A Idressorporate Park T(�l
c�14y 261-8252
CityState
Irving, 112714
CA Lic. # C6895
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Di 'si��on 3`I the4Business an�P�ojfe'ssionns Code, and my license is in full force and
effect. 1 F["16�w �6r-�•�.. 2+2 a _"
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,,usiness 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 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 or Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($5C0).
❑ 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 or 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 or completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose or sale.)
❑ I, as owner of the property, am exclusively contracting w,th 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's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
QGopy 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 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— Dale
Mailing Address
City, State, Zip
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:
Sq. Ft. 3306
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demoliticn ❑
Prunit does
not include afif
black walls
or tel.
Estimated Valuation
$359,144.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
1,199.50
Mech.
r
96. C-0
Electrical
/ f
189. Sl
Plumbing
). X :�
195.Ci
S.M.I.
`+
26.00
Grading
`1 � s% " t.
20.00
Driveway Enc.,
,
—8—
Infrastructure
(
5t7.28.39
Arr-s ars 1,1W11c:
ri-aces,-,
39.. 6
TOTAL
S r •
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. p $
UNITS
COLL. AREA
r K � P 1:
YARD SPKLR SYSTEM
2ND FL. ` SQ. FT. p
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ, FT. p
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. p
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO. FT. p
GROUT
•
DRINKING FOUNTAIN,
WALL SO. FT. p
FINAL INSP.
BOND BEAM
URINAL
SQ. FT. p
-
=$
ESTIMATED CONSTRUCTION VALUATION $
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(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. p c
BATH TUB
SQ. FT. p c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID p 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR p 3/ac
HOUSE SEWER
FINISH GRADING
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 UND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
%LAB 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 SIGNATURESIINITIALS
GARDEN WALL FINAL
'l
6
d
CITY OF LA OUINTA
D�ART�MENBOF PLANNING & DEVELOPMENT
ILDING DIVISION
JUIV Z 8 f�24-HOUR NOTICE -2246 OR INSPECTIONS
�a4,(J'IJ{ea ion' •�
Owe 3:M. Peters Co., Inc.
Contractor Same
Permit Number 13120
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOBADDRESS 79-770 Tangeloa
SFD Permit does not include -any
block walls or pool.
TYPE OF INSPECTION I DATE I INSP.
FOUNDATION & SETBACK
FOOTING STEEL !L/
MAIN GROUND SYSTEM
GROUND PLUMBING
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
O� —
Db N& POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
COVER NO WORK UNTIL ABOVE HAS BEEN SIGN D
DRYWALL INTERIOR /" _
POOL PRE PLASTER
POOL FENCE & GATE
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4!88