06504 (SFD)_ I - • 4--,4..
P.O. BOX 1504. No. 06504 A
Building78-105 CALLE ESTADO
Address 44065"Tiara 'Plitt' s LA QUINTA, CALIFORNIA 92253. _
Owner
Triad Pacific Desetr Davelopmat - BUILDING: TYPE CONST: OCC: GRP.
Mailing
Address 74-923 Rovle3l #130 La +t�tiata Highlands Ti 23269 -
"' A:P.,Number
City Zip Tel. ,
Palm. Desert 92260 1-349—,9174, Legal Description
ContractorLOt .
Project Description' ga Plan C-R
.
.,.Address
"City Zip Tela
State Lic.- City
& Classif. 505699 Lic. # 13$.3 • Sq. Ft. 1563 No. No. Dw: '
Arch., Engr., Size' � •Stories m Units".
Designer New ❑ Add ❑ ' Alter ❑ Repair ❑ Demolition ❑
Address' Tel.
City Zip State '
r Lic: #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that, am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Pr0fessi6ns7C0deyand'iny license is in hillJorce,and
effect: r, r ,' ; r / r r;• �� _X
•
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that 1 am exempt from the Contractor's License Law for the following Q
reason: (Sec. 7031.5,B $$ ^�usiness and Professions Code: Any city or county which requires a f
591
permit to construct, atter, improve, demolsh, or repair any structure, prior to its issuance also---------------
- -
requires the applicant for such permr7 to ft a signed statement that he is licensed pursuant to PERMIT- i 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 -•• 1
for the alleged exemption.. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep."
. subjects the appricant to a civilpenally 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. '• 489.0'/
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. • r3Q
Professions Code: The Contractors License Law does not apply to an owner of property who 8th nA
builds or improves60
thereon and who does such work himself or, through his own employees, Mech. _ .00 ,
provided that'such improvements are not intended or offered for sale. If, however, the. building - - ff
or improvement is said within one year of completion, the owner•buJder will have the burden Electrical - • ' , $0j� 1
of proving that he did not build or Improve for the purpose of safe.) - - r
❑ 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 Ucense Law - _ •
does not apply to an owner of property who buds or improves thereon, and who contracts for S. M,1. - 2 6.16
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec B. & P.C. for this reason Grading
Driveway Enc.
Date owner Infrastructure • ' I�97E4.F4 - .
WORKERS' COMPENSATION DECLARATION r,
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. '' '- • -
TOTAL L
CERTIFICATE OF EXEMPTION FROM REMARKS.
24{�a S j?.`.k _r +e"f p /k•..Q 7� -¢ ... �.:.', +r-,tt"i
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred (dollars (8100) valuation .. UlOt : 2. 1 U t t?i. _ i -.71* .3.. a:.'i . or less.)
I certify that in the performance of the work for which'this permit is issued, 1 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: ff, after making the Certificate of Exemption you should become ZONE: - - BY:
subject to the Workers', Corrpensatim . provsi ns of the Labor Code, you must • forthwith -
Comply With such provisions orthispemMshallbedeemed 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 y,
work for which this permit is issued- (Sec. 3097, Civil Code.) Side Setback from Property Line
Lender's Name
Lender's Address fS
This is a building permit when property filled out'signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 160 days.V
I certify that I have read this application and state that the above information is correct.ISSUed by:
` Date Permit i' '
I agree to comply with all city and county ordinances and state laws relating to building:. 3
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for inspection purposes Validated by:
Signature of applicant Date °
Mailing address ' - Validation:
City,,,State, zip • - _
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SQ. FT. @
DUCT WORK
ROCK STORAGE
FOUND. REINF.
MOBILEHOME SVC.
BAR SINK
FOR. Sp, FT. ®
REINF. STEEL
GAS (FINAL) �� TEMP: POLE
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SO. FT. ®
LUMBER GR.
INSP.3' O��
JFINAL
FRAMING / ;1 09V
INAL INSP.
DRINKING FOUNTAIN.
WALL Sp. FT.
REMARKS:
URINAL
SO. FT.
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
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 ® 1+/a c
SEWAGE DISPOSAL
SO.FT.GAR ® Vhc
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
SETBACKGROUND
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.
1/D4�AER LOOP
HEATING (FINAL4
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.
INSP.3' O��
JFINAL
FRAMING / ;1 09V
INAL INSP.
ROOFING t< L
I9 �Cfp%J �rC
I (/
or
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIR=
LATHING S14[U .0 -
MESH
/^+
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I