06502 (SFD)TAtyl
P.O. BOX 1504 No. 0,6602
Building4-125 Tiara �i�iC4" 7&105 CALLE ESTADO
Address , LA QUINTA, CALIFORNIA,92253
Owner _
Triad ??-cif c Desett Deivelop ztt,
Mailing BUILDING:' TYPE CONST.' OCC: GRP.
Address -74-923 ftvley #130 A.P. Number ti Ouinta Htahlastft TT 23269
City Zip Tel. '
al>t Assert X32264 34th -97 Legal Description
Contractor Project Description Lot, 3. Plan 1)
SAPUN
Address
- City
Zip
Tel.:
. State Lic.
& Classif- 305,699•.
City
Lic. # 1383
Sq. Ft. IM
Size . - . .
.No. No. DW.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address'
Tel.
City
'
Zip
l
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION'
I hereby affirm that I am licensed under provisions of•Chapter'g'(commencing with Section
700� of Division 3 of the Bu"sin"ess and'Professio�nsslCod}e; and my license is in fdll force'and
effect"arrJky!
SIGNATURE r`i`. - .%fS-t,r Y Y DATE
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reason:. (Set. 7031.5,Business and Professions Code: Any, city or county which requires a
permit to, construct, after, improve, demolish, or repair any structure, prior to Its issuance also
requires,the app8cant for such permit to roe 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 penally of not more than rove hundred dollars ($500).
❑ I, as owner of the property,
do thew P ��• or my employees with wages as their sole compensation, will
orK 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 inproves thereon and who does such work himself or through his own employees,
provided that such enprovemens are not intended or offered for sale. If, however, the building
orbryrrovement 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 safe.) - ..
❑ I, as owner of the property: am exclusively contracting with licensed contractors to con-
struct the projecL (Sec. 7044, Business and Professions Code:. The Contractor's License Law
does nor 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.)
❑ 1 am exempt under Sec B. & P.C. for this reason
;
Egtlmated VfllUatlOn^
$100,293-
PERMIT
- -
AMOUNT '
Plan Chk. Dep.
- -
Plan Chk. Bal.
' 535g -3p4
Const.
a •
643 ti,hr0 `
Mech.
.00- _
Electrical -
109 11S! ,p t ' • 7
•, - .509.841 .
Plumbing
�'�>_
D.
S.M.1.
_ _
- 7.07 -'
Grading
Driveway, Enc..
Date Owner
Infrastructure
'.2,256,59.
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers 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
YX
S3Fs+..• iti
CERTIFICAirE EXEMPTIONFROM -
WORKERS' COMPENSATIONINSURANCE
(This section need not be completed ff 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
,REMAEIKS
sf*+
,
:j� - :{. 1141"k. A O t'v r d;:''1'
• Date Owner
N077CE TO APPLICANT: ff, after making. this Certificate of Exemption you should become
subject to the Workers' Compensation' provisions of the Labor Code', _you must forthwith
tomptywith such Provisions orthis Permit shag bedeemed revoked.
ZONE: BY: -
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line -
coNSTRucnoN 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.) -
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
• expiration if work thereunder is suspended for 180 days.
.. -
FINAL DATE
Side Street Setback from Center Line
Side S.etback,from Property. Line.
♦ 0 - f
INSPECTOR
" 10/13/89
I certify that I have read this application and state that the above information is correct.
1 agree to compty with all city and county ordinances and state laws relating to. building
tonsWetion, and hereby "authorize representatives •of this city . to enter the above-.
mentioned property for inspection purposes.' •.
' , Issued by:
Validated by:
Date Permit
Signature of applicant Date'
Mailing. Address
, Validation:
City,. State, Zip
4
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF. /yn 2�J
rl ✓ I
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
10
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
DRINKING FOUNTAIN.
WALL SO. FT.
FINAL INSP.
BOND BEAM
URINAL
SO. FT. 0
GRADING
cu. yd.
$ —Plus—x$—=$
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
Sp. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FINISH GRADING
SO.FT.GAR ® V4c
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
-,-414—
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. /yn 2�J
rl ✓ I
040.r
AS (ROUGH) 3/ L)�
!
ETER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
10
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—x$—=$
LUMBER GR.
FINAL INSP.
FRAMING (. �2 1 7 C%
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREW LL
LATHIN `Z G Q�
MESH
INSULATIONISOUND L12 -lee
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE311NITIALS
GARDEN WALL FINAL
I