06826 (SFD)44
P.O. BOX 1504 N o .
Building 44-320 Sweetbush Lane 7&105 CALLS CALIFORNIAESTAD9
Address LA QUINTA, ORNIA 92253
Owner
La Quints Associates
Mailing
Address 43-876 Vashington St.
Cityp Tel.
F Pairs DesergZi922W 345-7543.
Contractor
. LA.' Wiliiafns $lett. Card.
Address
sam.
City 1ZiD Tel.:
State Lic. City
& Classif. 493919 Lic. # 1231
Arch., Engr.,
Designer
Address' Tel.
I 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
OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busaress 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 statementathat he is licensed- pursuant to
the provisions or 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 vfotafion of Section 7031.5 by 'any applicant. for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). f
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale.; (Sec. 7044, Buisness and
Professions Code: The Conuactoes License Law does not apply to.an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not intended or offered for sale. If, however, the building
or improvement is said wrilhrn one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project- (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 1 am exempt under Sec_ -&- P.C. for this reason
.,w�>�4 `;0Owner_1�Y._
Date u
WORKERS' COMPENSATION DECLARATION ~
I hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No " Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
' r �
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($ 100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any penton 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
subject to the workers' C*moensatron provskiris of the Labor Code, you must forthwith
comply with such provisions or this permit shag be deemed revoked.
t-"
CONSTRUCTION LENDING AGENCY
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:)
Lender's Name
Lenders Address
This is a building permit when properly filled out, "signed and validated, andis subject to
expiration if work thereunder is suspended for 160 days.
I certify that I have read this application and state that the above information is.corect.
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.
Signature of applicant Date'
Mailing Address
City,. State, Zip
BUILDING: TYPE -CONST. OCC: GRP.
A.P. Number Tract 22982 m Phase IV
Legal Description Cactus Fl r
Project Description Plan 38 " Lot 112
REMARKS ,nFrsOV}} i+�,ggt: •:4:'y r.133__rk _utas..
I �...a PYuff..L�' �.�d �—• s`271 -)A`1+.1 --
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date/11 Permit-
Validated
ermit
Validated by:
Validation:
Sq. Ft. g�33
Size
No.
Stories
No. Dw.
= Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
8602
PERMIT
AMOUNT
Plan Chk. Dep.
,
Plan Chk. Bal.
4M.03
Const.
581.E
Mech.
53.5
Electrical
aq, 4Z
Plumbing
C ..
S. M. 1.
t3 i3`9
Grading
Driveway Enc.
Infrastructure
TOTAL
,1.1>;C� . t
%'` i i
REMARKS ,nFrsOV}} i+�,ggt: •:4:'y r.133__rk _utas..
I �...a PYuff..L�' �.�d �—• s`271 -)A`1+.1 --
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date/11 Permit-
Validated
ermit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE 3 KD
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SO. FT.
FORMS
WhER OR SEPTIC
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH) '7/a!/ �O L
c
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. Sp. FT. @
FINAL INSP.
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN-
OUNTAIN.SQ
GRADING
cu. yd.
$ plus x$
=$
URINAL
SO.FT ®
FRAMING f e uo ll
FINAL INSP / C�
ESTIMATED CONSTRUCTION VALUATION $
/ Q�
r 3
r
J
/
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
LAUNDRYTRAY
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.
SQ. FT. ® c
BATH TUB
INSULATIONISOUND 6 W c/
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1V/i c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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 f
GROUND PLUM BIN / &
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 3 KD
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WhER OR SEPTIC
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF J /S O
GAS (ROUGH) '7/a!/ �O L
c
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. 8
FRAMING f e uo ll
FINAL INSP / C�
ROOFING _5140145?
/ Q�
r 3
r
J
/
((( v
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING /l V (3 Cr
MESH
INSULATIONISOUND 6 W c/
FINISH GRADING
FINAL INSPECTIO
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
1