04272 (SATT)P.O. BOX 1504
Building 78-105 CALLS ESTADO
• Address • 74t-429 Tatrat, C*tta Ct,� LA.QUINTA,CALIFORNIA 92253
• Owner.
041272'
MailingBOILDING:,*TYPE CONST:'OCC. GRP.M..
Address - ,777 S,' Main St. suits 106 A.P. Number. . 613-790-002
City Zip Tel.
92686 714 -
Legal Description
Contractor Legal
Descriptio'n
Address
-7::
State Lic.
& Classif. 462814',
Arch., Engr.,
Designer.
Address
F
W .
I el.
City
Lic. #
Sq. Ft.., 6 No. No. Dw.
Size- Stories Units
New 0 Add 0 Alter 0 Repair 0 Demolition'01,
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
SIGNATURE DATE
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason:.(Sec. 7031.5,Susiness 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 to file a signed statement that he is licensed pursuant to
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 thebasis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
0 1, 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
Professions Code: TheContractor'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,
ro
pvided 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-bugder will have the burden
of proving that he did not build or improve for the purpose of sale.)
0 1, 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.)
0 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
4U.4 0 UU
Mech.
JJ*UU
Electrical
Plumbing
.
S.M.I.
3. ib
Grading
REMARKS
Driveway Enc.
WORKERS' COMPENSATION INSURANCE
Infrastructure
V4
FrI1190-TOW
► A 0
WORKERS' COMPENSATION DECLARATION
I h;reby 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
0 Copy is filed with the city. 0 Certified copy is hereby furnished.
.
. TOTAL
I ;�Xtultllwo r
. _>'k S�
-
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($106) valuation.
or less.)
I certify that in the performance of thp work for which this permit Is issued, I shall not
A 1J q.X!,Atf X, S 4 5 A-4*, h J�*w 41W
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-.thg',Labor Code, you must forthwith
Minimum Setback
comply with such provisions or this permit shall be deemed revoked.',
Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
.,CONSTRUCTION LENDING AGENCY
Side, Street Setback from Center Line
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.) ";.,i_ .1
Side Setback from Property Line
Lender's. Name
Linder's Address
This is a -building permit when properly filled out, signed and validated, And is subject to
FINAL DATE
INSPECTOR
expiration it work thereunder is suspended for 180 days..
I certify that I have read this application and state that the7'ab6ve information is correct.
ssued by:
—,--Date Permit
agree to comply with all city and county ordinances arid'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, Zi
WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE,MARP COPY - FILE 4 t
CONSTRUCTION ESTIMATL
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO FT (p $
UNITS
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SO FT. a
DUCT WORK
ROCK STORAGE
FOUND. REINF. r/2 Z/��(�
` I�
MOBILEHOME SVC.
BAR SINK
POR SO FT. a
REINF. STEEL
GAS (FINAL) TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR SO. FT. to
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CARP. SO FT. a
LUM ER GR.
FINAL INSP.
WALL SO FT. td
FINAL FINAL INSP.
DRINKING FOUNTAIN
(elf / /�,
URINAL
SO. FT. rd
ESTIMATED CONSTRUCTION VALUATION S
WATER PIPING
NOTE_ Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
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
FINAL INSPECTION
SO. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ t % c
SEWAGE DISPOSAL
FENCE FINAL
SO.FT.GAR (g 3i4c
HOUSE SEWER
INSPECTOR'S SIGNATURESIINITIALS
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.rEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
NO PLUMBING%$ UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE —,?
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. r/2 Z/��(�
` I�
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 XS
=$
LUM ER GR.
FINAL INSP.
MING
FINAL FINAL INSP.
ROOFING
(elf / /�,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
MESH
!!UU !TIONISOUND.?
FINISH GRADING
FINAL INSPECTION
CERT. OCC:
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
•
City of LaQuinta
78495 CALLE TAMPICO
LA QUINTA, CALIFORNIA
(760) 777-7012 [FAX] (7 60) 777-7011
�O
INSPECTION RECORD
Permit. # 9808-002
STRUCTURAL RETROFIT OF UNIT
ADDRESS
DATE
INSPECTION
[YES/NO]
—IV2 -7;9�RRA
12-9-99
FRAMING/HARDWARE
PIAN TYPE:
INSULATION'
®/G •.
Contractor:
WERMERS MULTI -FAMILY CORP.
SHEAR NAILING
mK ..8 • J
,2 . jJ. Q8
DRYWALL
42..lev" _ 99
JOB FINAL
,L/
COMMENTS/NOTES:
Z. �oo� .�/Ry-�P.�P,�ies �/- - 98 Ud •J �aL/
2) AOOF' /1,1,4sZ L'OrV --7%C-'y.�=Qf J. f
MAILING ADDRESS — P.O. BOX 1504. LA QUINTA, CALLIFORNIA 92253