06582P.O. BOX 1504 No. 06582
l
Building 44-1503 Tiara Place78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
`IrAid Desert Pacific Dev.
Mailing BUILDING: TYPE CONST.- OCC: GRP.
Address 749923 Hovle.. #334 M A.P. Number La Quin to Higbilands TT 23269
City Zip Tel.
Palm— Daaer't 92260 340'-9174• Legal Description
Contractor _ Project Description Lot 10 Plan -A-1t
Address,
City Zip Tela
State Lic. City -
8� Classif. '. 505$99 Lic. # 1383 Sq. Ft. 1220 No. No. Dw.
Arch., Engr., Size - Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ '
Address Tel.
City .Zip State
r � rt Lic. #
f LICENS€D,CONTRACTOR'S DECLARATION, �
I hereby affirm that I am licensed under,Gr�ovisions of Chapter 9 (commencing with Section
7000) of Division 3 of the'BBu�siness and/pyr—of-e�ssions,Code; and-mydicense i§ in full for"ce.a d
effect. ' , 1' i i !f' "�. trld g ] ,: y 1 -s T
'
SIGNATURE / I-. cN•1` .✓ �k I DATE '
r ``.,O.WNER:BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation $67;445
. reason: (Sec. 7031.5,Business and Professions Code: Any city or• county which requires a r _
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also `• AMOUNT
requires the applicant for such permit to file a signed statement that he is licensed pursuant to - PERMIT -
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.
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 Plan Chk. Bal. - g5 I l • 15
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and, COr1St. .4 95 rJ
Professions Code: The Contractor's License Law does not apply to an owner of property who YY��
-builds or improves thereon and who does such work himself or through his own employees, Mech.-� ♦ V
provided that such Improvements are not intended or offered for sale. 0, however, the building C
or improvement is sold within one year of completion, the owner -builder wig have the burden Electrical ; ' ' 0 * 9 q
• of proving that he did not build or Improve for the purpose of sale.) _
O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ' 120.50
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law . _ ,
'does not apply to an owner of propertywho builds or Improves thereon, and who contracts for S.M.I. 4 *76
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
• •Grading -
O 1 am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure *5 ..51-
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
❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished. s r
TOTAL
CEIMFICATEOFEXEMPTIONFROM • '-REMARKS
WORKERS' COMPENSATION INSURANCE e.
R. - tsrt�ny i 0. a u.v ras... E > v p'R , u• r
(This section need not be completed If the Perrryf 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.
r
Date Owner
'NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become ZONE: BY: r
subject to the Workers' Compensation provisions of. the Labor Code,- you must forthwith _
comply with such provisions or thispermit shall be deemed revoked. ••Minimum Setback Distances: -
Fiont Setback from Center Line
Rear Setback from Rear Prop. Line'
colVsraUCTION LENDING AGENCY ' Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the'- • r .
• ,work for which this permit is issued. (Sec. 3097, Civil code.) . Side Setback from Property Line
Lender's Name
Lender's Address 1
This is a building permit when properly filled out signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. 0/24/
/'e34 f l 8 9
I certify that I have read this application and state that the above information is correct. Issued by: Da 4 Permit•
' I agree to comply with all city and county ordinances and state. laws relating to. building v
construction, and hereby authorize' representatives of this city to enter the above-.
mentioned property for inspection purposes. Validated by:
Signature of applicant Date i
Mailing Address „VBIldatlOtl:
City,. State„ Zip
t
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT.
DUCT WORK
ROCKSTORAGE
/yam
FOUND. REINF. I 3/
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL SQ. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SQ. FT. @
GRADING
cu. yd.
$ plus x$
_$
ESTIMATED CONSTRUCTION VALUATION $
n
FRAMING (�(y FINAL INSP. G
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
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.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, I // �f ELECTRICAL HEATING & AIR COND. SOLAR
.1 4 1f^�24�
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
ROCKSTORAGE
/yam
FOUND. REINF. I 3/
GAS (ROUGH) '7r'y D
✓
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. f/t (��
n
FRAMING (�(y FINAL INSP. G
ROOFING
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 1 D
MESH
INSULATIONISOUND 0
FINISH GRADING
FINAL INSPECTION O
CERT. OCC.
REMARKS:
(INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL