06583 (SFD)P.O. BOX 1504 N o . 06583
Building78-105 CALLE ESTADO
Address 44-1$ Ti$La Place LA QUINTA, CALIFORNIA 92253 _
-Owner
Triad Pacific Desert Dee. BUILDING: TYPE CONST:' OCC: GRP. -
Mailing
Address 74-923 Hov ley #139 A.P. Number La ante 91:9hlaZ dsp TT 232-69.
CityZip. Tel.
Palm b03 92260 340-9174 Legal Description
Contractor Project Description Lot 11, Plan D
Same
,Ad—dress .
City Zip Tel.:
State Lic. City
& Classif. 505699 - Lic. # 1383 Sq. Ft. 1813 No. No. Dw.
Size • Stories Units
Arch., Engr., a
Designer New ❑ Add ❑ • Alter ❑ Repair ❑ Demolition ❑
Address Tel.
CityZip State
Lic. #
jj LICENSED CONTRACTOR'S. DECLARATION
I hereby affirm that I,am �ltcensed undefprovisions of Chapter 9 (commencing with;Sectior�'
7000) of Division 3/of the Business a anyC�jofessions Code, and my license, iyin f(ull/force and
effect. 7 °~`• • J t� ilrT' [ .3 i I
SIGNATURE DATE`S
OWNER -BUILDER DECLARATION Estimated Valuation j
I hereby affirm that 1 am exempt from the Contractors License Law for the following -1 ii /.�q tp �'�9'J
. , reason: (Sec. 7031.5,Busfness 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 AMOUNT
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to PERMIT
the provisions or the Contractor's License Law, Chapter .9 (commencing with Section 7000) or
Division 3 or 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).
❑• 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 535.34--
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Cont.643.00,.--
Professions Code: The Contractor's License Lawdoesnot apply to an owner of property who
builds. or Improves thereon and who does such work himself or through his own employees, , Mech. 60.00 , ,
t - provided that such Improvements are not intended or offered for sale. If, however, the building'
or improvement is.sold within one year of completion, the owner -builder will have the burden Electrical 1��,.84
of proving that he did not build or Improve for the purpose of sale.) - _ t
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing t 132.50 w ,
struct the project. (Sec. 7044, Business and Professions Code: ,The Contractor's License Law .
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. -
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
• Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure 2t256.59
`
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 r
❑ Copy is filed with the city. O Certified copy is hereby furnished. r `es !
TOTAL,-- $3*744.36
CERTIFICATE OF EXEMPTION FROM REMARKS �'g+(, Y.V�Af? CJtx c r
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
or less.)
I 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•lhe Workers' Compensation
Laws of California. -
Date Owner '
NOTICE TO APPLICANT. g, 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: '1 `
comply with such provisions or this permit shall be deemed revoked. - -
Front_ Setback from Center Line
t 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 1 . .
,work forwhich this permit is issued. (Sec. 3097, Civil Code.), Side Setback from Property Line
Lenders Name
Lenders Address ,
This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE' INSPECTOR10/24M
A qA ips t^
expiration if work thereunder is suspended for 180 days. 10/ `4 � M j
I 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 - Date
Mailing Address Validation;
city,. State, Zip
y ' 1 A
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. a $
UNITS
-SLAB GRADE l 6
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
GAS (FINAU/—�!!,� TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. I SO. FT. ®
FINAL INSP.
WALL SQ. FT.
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ plus x$
-$
URINAL
SQ FT ®
ROOFING 2/ J%OHO
/ ? ✓ G
VENTILATION
FIRE ZONE ROOFING,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THI jG O
MESH
INSULATIONISOUN�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
I
/
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=� �l —7 / v � v G
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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 ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ec
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
M=CH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
1 ' fes_
SETBACK
GROUND PLUMBINJ-e UNDERGROUND
AO
A.C. UNIT
COLL AREA
-SLAB GRADE l 6
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.(
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAU/—�!!,� TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR. FINAL INSP. f%
FRAMING / gli� FINAL INSP.
ROOFING 2/ J%OHO
/ ? ✓ G
VENTILATION
FIRE ZONE ROOFING,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THI jG O
MESH
INSULATIONISOUN�
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
I
/
(/ GjI
=� �l —7 / v � v G
REMARKS:
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL