04271 (SATT)44Q04271
73»427 Serra Cotta Ct. P.O. BOX 1504
Building 78-105 CALLE ESTADO r - - •• G Y
.r- Address zoul evard Development wLA.QUINTA, CALIFORNIA 9225.3
.Owner
&777 S. Main st, # Suite 106
n_MailingBUILDING: TYPE CONST. - � OCC. GRP.
�.
Address A.P. Number' 6 V%--7qt—A1_1j2
City Zip Tel.
Legal Description
Contractor Project Description _ ! ! �P �► _
Palm i4 tiifA�r1� �- Plan 3 Building 19
Address
City Zip Tel.
State Lic. City
& Classif. 462814 Lic. # Sq. Ft ri;6 No. No. Dw.
Arch., Engr.,
Size `' Stories `" Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address r , Tel.
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. ` �F xd +l �• r. - r.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, atter, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile a signed statement that he is licensed pursuant to
the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 o/ the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation o/ Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
D 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, euisness and
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,
provided that suchimprovements 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
o/ proving that he did not build or improve for the purpose o/ sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
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
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
Date Owner
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.
CERTIFICATE OF EXEMPTION FROM
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 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: If, sitar making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must. forthwith
comply with such provisions or this permit shall be deemed revoked.
Estjmate0 Valuation
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
FriFt a—Toed L
TOTAL
AMOUNT
3044.00
33.441
X43r.47
iP- •tTV
3.96
lv299.944
REMARKS
•-+;#S"Q+. tkl'� 3'f,+4:ft•,1F;A..3'`�%'3d C !'t l".►
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
City, State, Zip
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
1 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
INSPETOR
C
This is a building permit when properly filled out, signed and validated, and is subject to
-INSPECTOR
p
8
7/7/88
expiration if work thereunder is suspended for 180 days.
i ! ! awl
1
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
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
iST FL SO FT !p S
UNITS
COLL. AREA
RADE ZG -AC�;
ROUGH PLUMB
YARD SPKLR SYSTEM
2ND FL SO FT. C
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FT. or
DUCT WORK
ROCK STORAGE
`�
OUND. REINF/% —7 /�� 1!/
C� �f
POWER OUTLET
ROOF DRAINS
GAR SO. FT. ftt
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SQ FT. �
WALL SO. FT. a
WATER HEATER
DRINKING FOUNTAIN
FINAL INSP.
URINAL
SO. FT. (a
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
$ plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ TV. c
SEWAGE DISPOSAL
SO.FT.GAR rg 3:c
HOUSE SEWER
'�
fSULATIONISOUND3—
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.PEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR
S BACK
ROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
RADE ZG -AC�;
ROUGH PLUMB
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
`�
OUND. REINF/% —7 /�� 1!/
C� �f
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.
AMING --2-5-
FINAL INSP.
iv ROOFING
��
REMARKS:
VENTILATION VENTILATIONi/i
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GA FIREWALL
_r
'MES'
'�
fSULATIONISOUND3—
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE'SlINITIALS
GARDEN WALL FINAL
'City of. . Law, uinia
78.495 CALLE TAMPICO
LA QUINTA, CALIFORNIA,
(760) 777-7012 [FAX] (760) 777-7011
INSPECTION RECORD
Permit # 9808-002
STRUCTURAL RETROFIT OF UNIT
p ADDRESS
DATE
INSPECTION
[YES/NO]
./,Z - - 98
FRAMING/HARDWARE.
PLAN TYPE:
/,2- 9- 98
INSULATION
Contractor:
WERMERS MULTI FAMILY CORP.
/2 -ID- 98
SHEAR NAILING
�.f.
1,2-11-96
=
DRYWALL
cK
98
JOB FINAL
L
COMMENTS/NOTES: '
MAILING ADDRESS - P.O. BOX 1504. LA QUINTA, CALLIFORNIA 92253