06432 (RPL)Building „
Address 78-740-1
Owner
P.O. BOX 1504
7-105 CALLE ESTADO .
' LA QUINTA, CALIFORNIA 92253
Mailing
BUILDING: -TYPE CONST. OCC: GRP:
Address sme
A.P. Number N• %i"62-'.012
City
Zip
Tel.,,,,
La. Qulmt8
92253
564-4832..:
Legal Description
pool � .s a ti
Project Description • �
Contractor
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Address K
,
.
78--755 Martinique
Plan Chk. Dep.
❑ I, as owner of the r
property, am exclusively contracting with licensed contractors to con-
Tell
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ie Ditme€
Tioltiwda92201
4345--5070,.
does not apply to an owner of property who builds or bnproves thereon, and who -contracts for
State Lic.
City.
t.
& Classif. 476807
Lic. # �.��
Sq. Ft. No. No. DW.W .,
Size . Stories ^ Units' •. ••
' Arch., Engr.'
' Designer
New ❑ Add ❑' Alter ❑ Repair ❑ + Demolitiori ❑
Address
avo
Tel.
City
Zip
State
Lica#
• :x Pio/essions Code: TAe Contractors License Law does not appty to an owner o/ property who
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
`'-''builds or 6nproves thereon and who does such work hfmse!/ or through his own employees,
provided that such anprovemenls are Trot urtended or offered /or sale. I/, however, the building
Mech.
-
SIGNATURE - DATE
_ or improvement is sold with one year of completion, the owner -builder will have the burden�
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
.: reason: (Sec. 7031.5,0usiress and Professions Code: Any city or county which requires a
permit to construct, after, irpmove, demolish, or repair any. structure, prior to its issuance also
iequlres the applicant for such permit to'Re a signed statement that he Ls licensed pursuant to
tfhe;:piovislons"o/ the Cantiador5 License Law, Chap[er 9 (commencing wltA Section 7000) of
Division 3' ol, the Business and Prolessbns Cade, or that. he !s exempt there/rom, and the basis
-roti`fhe'alleged'•�ezerrption. Any vkrfation of section 7031.5 Dy ,'any appgcant for a -permit
•'•'rt `D' r (he 6canrro 1 - .
_
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Estimated Valuation
PERMIT.
-
Plan Chk. Dep.
$131000
AMOUNT -
. su /ec s - app a perrafty o trot more than five hundred dollars.l$500): "
:r'O'I;"'as owner of.the property, or my employees with wages as their sole compensation, will
an
PlChk. Bal.
','do the work'and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
COnst:.
• :x Pio/essions Code: TAe Contractors License Law does not appty to an owner o/ property who
�
144.. 00-
`'-''builds or 6nproves thereon and who does such work hfmse!/ or through his own employees,
provided that such anprovemenls are Trot urtended or offered /or sale. I/, however, the building
Mech.
-
4�p r�pq
30.00
_ or improvement is sold with one year of completion, the owner -builder will have the burden�
- _
EleCtrIC31
_
I - - R -
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o/ proving that
.. t he did not bold or rrprove for the purpose o/ sale.) -
r
b C.1
•
❑ I, as owner of the r
property, am exclusively contracting with licensed contractors to con-
Plumbing � '
�t#'r.�0
- 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 bnproves thereon, and who -contracts for
S.M.I.
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such projects with a contractors) 8censed pursuant to the Contractor's License Law.)
Grading
• ❑ 1 am exempt under Sec R. & P.C.-for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKED' COMPENSATION DECLARATION
I hereby affirm that 1 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 furnished..
CFJITIFICATEOF EXEMPTION FROM. -
REMARKS
r
i!':7 « °3_. tr kl ::: «':~[3
WORKERS? COMPENSATION INSURANCE
(This section need of be completed if the permit is for one hundred dollars ($100) valuation
` -
. ,f1' .'.� , •
� �r `2+4 � 'r d a•' -S r s •� .n.
. or less.) - -
I certify that in the performance of thg work for which this permit'is issued, I shall not
employ any erson in any manner so as to become subject to the Workers' Compensation
Laws of Califpornia
' Date' Owner
"
NOTICE TO•APPLICANT• 0, after mabV Nis - Certificate of Exemption_ you should become
ZONE:
BY:
sub%ect'to the Workers' Canpensation provisloris of the Labor ,Code, you must forthwith
comply with such provisions or this permit shag be deemed revoked.. - -
Minimum Setback Distances: •'
( _
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 performanceof the
_ . work Ior which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lenders Name
Lender's Address
'.
FINAL.DATE
r y -
This is a building permit when properly filledout,'signed and validated,"and is subject to ..
expiration if work thereunder is suspended for 180 days. • _;
-
aINSPECTOR
•, ♦(0/2189 -
I certify that I have read this.application and state that the above information is correct_
Issued by:
Date Permit �j "' -
I agree to compry with all city and county ordinances 'and state laws relating to building -
_
-
construction; and hereby' authorize representatives .of this city 'to' enter the .,above-..
4 "
mentioned property for inspection purposes.'
-
Validated by:
�-
t Date
Signature of applicant
. Mailing Address
Validation:
City;. State, ZIP'
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST 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) 2/1-1 (C�!!
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.
WATER SYSTEM
DRINKING FOUNTAIN.
GRADING
cu. yd.
$ plus x$
=$
URINAL
SO FT ®
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE Not to be used as property tax valuation
REMARKS:
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
SPARK ARRESTOR
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
INSULATIONISOUND
SO. FT. ®c
IWATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
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
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.
/
GAS (ROUGH) 2/1-1 (C�!!
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.
FRAMING
FINAL INSP.
ROOFING
P//n� /fes
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REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I