04193 (SATT)• P.O. BOX 1504
Building 78-105 CALLE ESTADO
`
Address 8-417 `terra Cotta Ct • LA QUINTA, CALIFORNIA 92253 '
Owner
Mailing BoUE3Vffir$V'139mef� BUILDING: TYPE CONST. OCC. GRP.: � t
.Address 777 S; 4ai t . ♦ Suite
1.0
... A.P.�Number - 613-"790-002
City Zip Tel. ,`
orange 92686 714-547ts 0,5� , , Legal Description
Contractor Project Description Building ~i3♦ Plan '2
Sam _
Address
b,
City Zip Tel.
State Lic.City '
' & Classif. 462614, Lic. # Sq. Ft. No. No. Dw.
•
Arch., Engr., Size 912 Stories Units
-• - -
r Designer New ❑ ' ' Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. `
tlargae included
City Zip State
Lic. #
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. r +
SIGNATURE • - ' DATE '
OWNER -BUILDER DECLARATION j Estimated Valuation$65#225 I hereby affirm that I am exempt from the Contractor's License Law for the following X75 # 225
..
. reason: (Sec. 7031.5,Business 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
requires the applicant for such permit.lo file a signed statement that he is licensed pursuant to . PERMIT AMOUNT ,
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. 1�
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. BBI. 061.
O I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COf1StI .#• P1raaM'
Professions Code: The Contractor's License Law does not apply -to an owner of property who .
IyC V y� 0r
builds or improves thereon and who does such work himself or through his own employees, Mech. ,� J ! V 0
provided that such Improvements are not intended or offered for sale. If, however, the building J� sur
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical+1 Y i
of proving that he did not build or improve for the purpose of sale.) _ 6
y
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing { J .00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law _ p
does not 'apply to an owner of property who builds or improves thereon, and who contracts for S.M,I. y
such projects with a contractor(s) licensed pursuant to the Contractor's license Law.)
Grading _
O 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure VIP 461 i5*7- -
FrIPtle'^ TOO L Zard 318'419
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 a`+`rdl#272.71'�"3."ii
CERTIFICATE OF EXEMPTION FROM REMARKS S
WORKERS' COMPENSATION INSURANCE �•,t��� 33 !�1
(This section need not be completed it the permit Is for one hundred dollars (5100) valuation f(7i •+l A��.% 'f': •�-�t:}Yr�i a'�Iw.l `•cinch i� �f_�
or less.)
I certify that inthe performance of thg 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: d, 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 MOM
/
expiration It work thereunder is suspended for 180 days.
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 I city to enter the above-
mentioned property for inspection purposes. Validated by:
Signature of applicant_ Date -
Mailing Address Validation:
'City, -State, Zip
WHITE FINANCE, PINK; APPLICANT, GREEN - BUILDING, GOLDENROD ASSESSORS OFFICE, HARD COPY - FILE
-..a -► ^" :! :,H -+e .T., ,.; .,,, S..fi.. ri7 - � _. .,. ., ar. .. ..a .. L... - r.... w ., .> .. -.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT (p $
UNITS
GRADE Z 6 P
ROUGH PLUMB
BONDING
YARD SPKLR SYSTEM
2ND FL SO FT. R
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING •
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
GAS (ROUGH)
METER LOOP
GAR SO. FT. Ft
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CARP. SO FT. 0
GROUT
WATER HEATER
WALL SO. FT. (a
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. (a
_ $
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
/
^�� �
7/( . %-
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTONDISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIREPLACE
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% c
SEWAGE DISPOSAL
SO.FT.GAR rg 3/.c
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 8 AIR COND. SOLAR
SETBACK
OUND PLUMBING" -%D
UNDERGROUND
A.C. UNIT
COLL. AREA
GRADE Z 6 P
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING •
DUCT WORK
ROCK STORAGE
. REINF.��f /t,/�
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.
$ plus x$
_ $
LUMBER GR.
FINAL INSP.
/y
AMING yS
FINAL INSP.
ROOFING
_(/
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/
^�� �
7/( . %-
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
NG
MESH
I TION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL'
INSPECTOR'S SIGNATURESlINITIALS
GARDEN WALL FINAL