07992 (RPL)TAty
P.O. BOX 1504 N o . 07992.
Building78-105 CALLE ESTADO
Address 186 Tiara LA QUINTA, CALIFORNIA 92253 '
Owner
Ed $
Mailing BUILDING: TYPE CONST. OCC: GRP.
- -185 Tfrar U -Quanta Highl`ands
Address '
City Zip Tel. .
A.P. Number
U QuUta 9L7253 Y 64- Legal Description
Contractor Project Description-AgIll t.
Address
43 -560 -Pall Carle -
City Zip Tel.:
State Lic:t City
& Classif. ; z Lic. # 15 Sq. Ft. No. No: Dw. '
" Size Stories. Units
Arch., Engr.; , ;
Designer: '`- New ❑ Add ❑ Alter ❑� Repair ❑ Demolition ❑
Address �_ Tel. r.-
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION'
I herebyy affirmsthat I am licensed under provisions of Chapter 9 (commencing with Section a
7000) of,Division 3 of the Business,and Professions''Code, and my license is in full force and
. )
effecLlrrrr
SIGNATURE- ,yt `c•-^,�''" .. =•r" .. DAT
' c- . OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business 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 r 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. ULM
do the work,' -and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. .
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, Mech. - - '
provided that improvements are not intended or offered for sale.. If, however, the building
30460
or improvement Is -sold within one year or completion, the owner -builder will. have the burden Electrical -
of proving that. he did'not build or improve for the purpose of sale.) -
O'I, as.owner.of.tha property, am exclusively contracting with licensed contractors to con- Plumbing���
struct the project: (Sec. 7044, Business and Professions Code: The Contractor's License Law
doe§ not apply to an owner of property who builds or improves thereon, and who contracts for S. M. 1. 'fi >
{.: such projects with a contractors) licensed pursuant to the Contractor's License Law.) _
f" Grading
0 l am exempt under Sec. - B: & P.C. for this reason -
Driveway Enc.
,Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby'affirm that,l 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. O Certified copy is, hereby furnished.
TOTAL MC 11
-
CERTIFICATE OF EXEMPTION FROM REMARKS `
WORKERS' COMPENSATION INSURANCE'v-
(This section need not be completed if the permit is for one hundred dollars ($100) valuation. - •6`2iARF' {-xt"� Xr;,%Q.'�`$' or less.)
l.certify that in the performance of the 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 - ZONE: BY: - -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.. ,
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
work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback, from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated; and is subject to
expiration it work thereunder is suspended for 180 days. cc n /90
I certify ttfat:l have read this application and state that the above information is correct. Issued by: ' Date 3 Zai 90permlt
• 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 Address Validation:
City, State, Zip
v a rR - - r r ,� . "t"1 t�.44"pf. s
i� i.r•r i �',�, -'t}� : '.Z� �' z -..,. }r �f, � i ' � i-- � - .t - w+ f �. • 1.. ..,.a 1 ,.a-
;,�;_ • + .1. , �.:, &. 4. - (« ^.k 3 %_.;`y-ts.e -t<� ►.... ,�- :ii `!a -;5 . r::4 - .'y��-i._ , Y. , -,>� 4. sY. ,
s
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ, FT. ®
POWER OUTLET
ROOF DRAINS
CARP. SQ. FT.
GAS (ROUGH) 6 C,, k'- METER LOOP
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYEFI
FRAMING
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.
SQ. FT. RESID ® 1114 c
SEWAGE DISPOSAL
LATHING
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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
GROUND PLUMBING rCj UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. Q BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) 6 C,, k'- 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.
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 SIGNATOR=SIINITIALS
GARDEN WALL FINAL