12972 (SFD)J y414a
P.O. BOX 1504 NO. 12,972
Building 78-105 CALLE ESTADO
Address 78-500 Tr junga LA QUINTA, CALIFORNIA 92253
Owner
AM Builders
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address P.O. Box 366 A.P. Number 769--061-007
City Zip 7��564-4832
Asa duinit�:a, Cid92253 Legal Description Lot 14 Desert Club brae ,
Contractor ' S3
sm Project Description
Address .
City, Zip
State Lic. 48754 City 626
& Classif. Lic. # Sq. Ft.' 1851 No. No., Dw.
Size Stories Units'
Arch:, Engr.,
Designer ' New 4i Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Address -' Tel.
Permit includes 6t block wall. 20'l- from
City,-.' : ' f Zip State , front property line. '
J Lic. #
LICEND CONTRACTOR'S DECLARATION
I hereby affirm that I am licenseSEd 4Cder provisions of Chapter 9 (commencing with Section
7000) of Division 3 d the Business and Professions Code, and my license is in full force and -
effect
.•
SIGNATURE T, DATE
y OWNER -BUILDER DECLARATION Estimated Valuation a yy�q y
�l hereby affirm that I am exempt from the Contractor's License Law for the following $1.1.3 yr 1 ! is 00 "
reason: (Sec. 7031:5,Susiness 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• AMOUNT
requires the applicant for such permit to rite 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 thathe isexempttherefrom, and the basis
for the alleged .exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. 2.54.00
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk• Bal. -328.09
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Ea a
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. a 688. 5v
Professions Code: The Contractor's License Law does not apply to an owner of property who A
+- builds or Improves thereon and who does such work himself or through his own employees, Mech. •r r •i • '� . 00 "
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 , �, �•'
of proving that he did not build or improve for the purpose of sale.) .
23
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 144. 00
' 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. + 11. 40 �1
- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason Grading 20 00• q
Driveway Enc. —0—
Date ~owner - Infrastructure 2,36:5.2.3
Arts in. Pu c Places 32.94'
WORKERS' COMPENSATION DECLARATION
I hereby`iffitm that I have a certificate of consent to se -iAsure,or�certificate of ,
Worker's Compensation Insurance, or a celitf'.tld cop •the e, es 7.806rbeft7Code.) .
Policy No. Company
❑ Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL 4439.39 3,789.39
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE 7
(This section need not be completed if the permit is for one hundred dollars ($100) valuation ,,,,. <.r.n .R'a�. :t.!:i ?! f41`6 — +i 9--.Si.:4
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 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 1
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.
I certify that 1 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
Mailirig,Address Validation: '
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR SO FT ®
GAS (ROUGH) 8-"3`n
J
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. @
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. @
FINAL INSP.
WALL SO. FT.
-
DRINKING FOUNTAIN,
GRADING
cu. yd.
$ plus x$
_$
URINAL
SO FT @
FRAMING
FINAL FINAL INSP. -a
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
VENTILATION
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIREPLACE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SO. FT. @ c
BATH TUB
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/<c
HOUSE SEWER
CERT. OCC.
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 S AIR COND. SOLAR
SETBACK
GROUND PLUMBING��/y
(;7l1NDERGROUND
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.
GAS (ROUGH) 8-"3`n
J
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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. Cl �8�3
FRAMING
FINAL FINAL INSP. -a
ROOFING �_/``/_`� [�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING "9 3 C.0
MESH
INSULATIONISOUND,
�r
FINISH GRADING
FINAL INSPECTION j —' .,Q/
u+
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL