04163 (GRES)P.O. BOX 1504 -
'Building 78-105CALLE ESTADO• .
Address 78-301 Teira Cotta Ct• LA QUINTA, CALIFORNIA 92253.'
Owner,FµU
Boulevard DaVQ10P aent f BUILDING: TYPE CONST. OCC. GRP.
Mailing
Address 777 S.1Hain " St. tt s4te • 106 , X13-790-001
• -• A.P. Number
City Zip Tel.
92685 x_'14-X447-,Wfi Legal Description
Contractor Project Description Building S* Plan I
Same
Address
, s Y
City JZip Tel.
State Lic. City
& Classif. 462811 Lic. # Sq, Ft. _ -916 No. No. Dw. ,
Size` "Stories Units.
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ 0 Demolition ❑
Address Tel.
Garage included '
City Zip State
• - Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 herebyy �affirm that I am licensed under provisions otChapter 9 (commencing with Section pi a
7000) of.Division 3 of the Business and Professions Code, and my license is in full force and
effect "��?,
'SIGNATURE— ._Y.4.' - - • DATE
OWNER -BUILDER DECLARATION f
-herIeby a•f -:i• Estimated Valuation "_ $66 p 73 j,
`• =; I -hereby affirm that I am exempt from the Contractor's License Law for the following
reason: , (Sec: -t 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
•
requires! the 'applicant for such permit to file a signed statement that he' is licensed pursuant to PERMIT ': AMOUNT
the-proyisioris 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). ~
Plan Chk. B81.
[11, as owner of the property, or my employees with wages as their sole compensation, will 1', r •''
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. J, 44 # k)U.
Professions Code: The Contractor's License Law does not apply to an owner of property who -
' builds or improves thereon and who does such work himself or through his own employees, Mech. 4' 03 a U U
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 4:J' .'
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
struct the project. (Sec. 7044, Business and Professions Code.,. The Contractor's License Law - -
'j
'-,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 tothe Contractor's License Law.) .
' O I am exempt under Sec. B. ti P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure
Fringe-Toack 1 1wruY
�\i . 1r i.+ •.
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I' 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. ❑ Certified copy is hereby furnished.
TOTAL�i.,',1.
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred dollars ($100) valuation W.?x�' 4..y :,i '_.E} " { '" i:�"Y, 'j, :�++'a �. j.•��'
•' or less.) '
I certify that in the performance of the work for which this permit is issued, I shall not .
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
ZONE:
BY: • ' '
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
Minimum Setback
Distances:
comply with such provisions or this permit shall be deemed revoked. ,.
Front Setback from Center Line
' -
Rear Setback from Rear Prop. Line
- CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lender's Name
Lender's Address
• This is a building permit when properly filled out, signed and validated, and is subject to
FINAL DATE
INSPE%cTOR
/'�
expiration if work thereunder is suspended for 180 days.
` y
I certify that I have read this application and state that the above information is correct.
'
Issued by:
' Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this.'icity to enter the above-
mentioned property for inspection purposes.
Validated by:
Signature of applicant` Date
''
�?
Mailing Address
Validation:
-
City, State, Zip
`t WHITE - FINANCE PINK - APPLICANT, GREEN BUILDING, GOLDENROD - ASSESSORS OFFICE HARD COPY - FILES
r,.
t
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
iST FL SO FT ($
UNITS
ROUGH PLUMB
BONDING
HEATING (ROUGH)
YARD SPKLR SYSTEM
2ND FL SO FT.
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
MOBILEHOME SVC.
BAR SINK
POR
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
OUTLET
ROOF DRAINS
GAR SO. FT. toPOWER
GROUT
WATER HEATER
DRAINAGE PIPING
CAR P. SO FT. tag'
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN
WALL SO. FT. Q
LUM GR.Ler
FINAL INSP.
AWAMING
FINAL INSP.
URINAL
SO. FT. (d
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
VENTILATION
FLOOR DRAIN
MECHANICAL FEES
FIRE ZONE ROOFING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
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, TEMIPERM
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 1 1% c
SEWAGE DISPOSAL
CERT. OCC.
SO.FT.GAR r 3.c
HOUSE SEWER
FENCE FINAL
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 99e=
if_ELECTRICAL HEATING 8 AIR COND. SOLAR
��
SETBACK
GROUND PLUMBING J� UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS "v
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF//"/�'-04
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd./PER
plus x$
_$
LUM GR.Ler
FINAL INSP.
AWAMING
FINAL INSP.
OOFING2—
v !" -'
REMARKS:
!
VENTILATION
FIRE ZONE ROOFING
y
FIREPLACE
SPARK ARRESTOR'
GAR. FIREWALL
LATHING
MESH
N9ULATIONISOUND
FINISH GRADING
FINAL INSPECTION
'
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESlINITIALS t
GARDEN WALL FINAL
city of LaQui*nta
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA O
(760) 777-7012 [FAX] (760) 777-7011
INSPECTION RECORD
Permit # 9808,002
STRUCTURAL RETROFIT OF UNIT
ADDRESS
DATE
INSPECTION
[YES/NO]
Pg-3Q / 1�22fI (, 7Y q
- 99
FRAMING/HARDWARE
PLAN TYPE:
,j�- 9�
INSULATION
p�
Contractor:
WERMERS MULTI -FAMILY CORP.
/D - 29 - IB
SHEAR NAILING
/d -,2 9- 98
DRYWALL
/,2 - /D
JOB FINAL
law �-
COMMENTS/NOTES:
MAILING ADDRESS — P.O. BOX 1504, LA QUINTA, CALLIFORNIA 92253