06580 (SFD)Building
Address
P.O. BOX 1504 N o . �✓ �/
44-090 Iriara Place. LA QUINTA, CALIFORNIA 92253
Owner
• Traid-{Pacific Desert nev•
Mailing
Address 74-223 RO'` Iev #130
City 1 I Zip ITel..
w+nracivr ,
Address
L,Ity + + I[Ip
State Lic. I
& Classif• S5,5699 '
Arch., Engr•, I
Designer
11LDING: TYPE CONST. OCC: GRP. •
P._Number Lam. Q€ inter HigMAli -, TT 23269
gal Description '
oject Description LOt A..Plan C-R
t,Ity
Lic. # 138-3Sq. Ft. 1563 No.
_L] Size _ Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑.
Address
Tel.
t
City `
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that JI am licensed under Rrovisions of Chapter 9 (commencing with Section
7000) of Division 3 of+the�lBusiness and•Professions Code, and my licensee Is infullJorce-and
..effecL • f
a� �.i%•xf
"{! li t / 1~ f ✓ jr
M
SIGNATURE f"+•j" " i.' '/l it Sts / `" ODATE
OWNE iIUILDER DECLARATION '
m e
` I hereby affirm that I axempt from the Contractors License Law for the following
Estimated Valuation
reason: (Sec. 7031.5,13usuress 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 applicant for such pemrft to fife a signed statement that he is licensed pursuant to �
PERMIT fAMOUNT '
the provisions of the Contractors. License Law, Chapter _9 (commencing with Section 7000) of
s -
• Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
• for thealleged exemption. Any'vft-dcn of Section 7031.5 by any applicant for a permit
-
Plan Chk. Dep.
subjects 'the applicant to a civil penally of not more than rive hundred dollars ($500). -
- -
Plan Chk. Bal. ` 4U990-7
01, 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
('iOr1St.
Prolessiorrs Code: The Contractors License Law does not apply to an owner of property who
bu&ft or= thereon and who does such work himself or through his own employees,
Mech. C t3. 4l0-
' provided that such improvements are not intended or offered for sale. If, however, the building
-
orimprovement is sold within one year of completion, the owner -builder will have,the burdenElectrical
01 -
'
of proving that he did not build or improve for the purpose of sale.)
•.Zi,
0 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing 120 6_50
• struct the projecC (Sec. 7044,18usiness and Professions Code: The Contractor's License Law
does not apply to an owner_ of property who builds or bnproves thereon, and who contracts for
_
- G • L,•
S.M.I. - V 6, ”
- such projects with a contractor(s) licensed pursuant to the Contractor'sLicense Law.) - -
�'
Grading
❑ I am exempt under, Sec
B. & P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
, -
I 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
O Copy is filed .with the city. . O Certified copy is hereby fumished.
j
TOTAL 73 3-33+r2
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
• (This section need not 6e completed if the permit is for one hundred dollars (8100) valuation
�, €} '��J� i k�k.�•-F•�t„ ;( �� �t'. v�;l� '
• or less.) • .
_
1 certify that in the performance of thg 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 Califomia
j
Date Owner
' -.NOTICE TO APPLICANT ff, after making this Certificate of Exemption you should become
• N
ZONE: BY: -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
r>;•Complywrmsuch provisions orUmPermit shall bedeemed revoked, ..
-
Minimum Setback Distances:
Front Setback from Center Line.
"
Rear Setback from Rear Prop. Line •
• CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
yr I hereby affirm thatthere is a construction lending agency for the performance of the
- - •.
work for which this permit is issued. (Sec. 3097, Civil Code.)
-Side Setback from Property.Line
Lenders Name
��' -
}ECTOR
Lenders Address l'
,FINAL DATE INS
h Yq �q OR
- 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..
- V 24 89
r.
' 1 certify that I have read this application and state that the above information is correct.
'
Issued by:- Date Permit
• 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
Validated by: ;
Signature of applicant • I Date
• Mailing AddressValidation:
'
City,State, Zip
(
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1.
.. _ •. ... ., + ,
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL. SQ. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF. IV, /07
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
REINF. STEEL
GAS (FINAL) `, TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
FINAL INSP.
I
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SQ. FT. @
LUMBER GR.
FINAL INSP. ,L 7 �
od
FRAMING �
—
FINAL INSP.
DRINKING FOUNTAIN.
WALL SQ. 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
MESH
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
CERT. OCC.
SQ. FT. ®c
I WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
INSPECTOR'S SIGNATURESIINITIALS
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GARDEN WALL FINAL
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING i i ELECTRICAL I HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBIN3 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 1 U7
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
^^
SEWER OR SEPTIC TAN .0P ''ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. IV, /07
GAS (ROUGH) �% .� j/ 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. ,L 7 �
od
FRAMING �
—
FINAL INSP.
ROOFING -7//W �
�
'n
U
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 2 QD�j
MESH
INSULATIONISOUND r �®
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL