06854 (SFD)r izkIrav "
P.O. BOX 1504 - 4,
Building 78-105 CALLE ESTADO
Address 44.425 Stet-Wsh Lane LA QUINTA, CALIFORNIA 92253
Owner ... - .. '
La Quinta Associates
BUILDING: TYPE CONST OCC: GRP:.
Address 43475 Wa$hin . ton .St. A.P. Number 'Tract 22982 - Phase I.V ,
; . City Zip Tel. Gdrtus F1't wr
.Palm Desert �322$� 345 -?.54$ Legal Description ;
Contractor , Project Description Plan 4CR Lot- 1I9
E.G. W4lliaflis Dev. Corp.
Address ..
Sam
City Zip Tel.:
State Lic: = City
& Classif- • 493919 Lic. # 1231
Arch:; Engr.,
Designer
• i
Sq. Ft.1% No. No. Dw
Size Stories Units
New ❑ Add ❑ - - Alter ❑ Repair ❑
Demolition ❑.
Address'
Tel.
:. .
City, x
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 Professions
and Code, and my license is in full force -and
. .effect. •' - -
- -y
SIGNATURE - - DATE
•,d
OWNEpBUILDERDECLARATION
1 herebyaffirm that 1 am exempt from the Contractor's License Law for the following
Estimated. Valuation^
reason: (Sec. 7031.5,Busfness 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 We a signed statement that he is.licensed pursuant to
_
PERMIT T AMOUNT '
• _ the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
-the
Dvision 3 o) Business and Professions Code, or that. he'is exempt therefrom, and the basis
for. the afleged,exemptron. Any violation of Section 7031.5 by 'any applicant for a permit
A' -
Plan Chk.-Dep. - �, , '•
subjects the applicant to a civil penalty or not more than rive hundred dollars ($500).
I,
Plan Chk. Bal.f
❑ 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
Const.
r Professions, Code: The Contractors License Law does not apply to an owner or property who
-� '•
. builds or, improves ,thereon and who does such work himself or "through his own employees, •,t
_ '�S ••
MBCh.
.provided that: such improvements are not intended or offered for sale. If, however, the building
improvement is
or sold within one year or completion, the owner -builder will have the burden+
EleCtrlCal
of proving that he did not build or inprove 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 Contractors License Law
-•� does not apply to''an owner of property.who builds or improves, thereon, and who contracts lor.
S.M.I.-
such projects with a'comiactor(s) licensed pursuannt.to the Contractor's License Law.)
11
❑ 1 am exempt under Sec B!ti P.C. this reason Y
Grading I
•
.� �•
-
Driveway Enc.
7-
Date 3 /3,/ ' .3Ower, i °
Infrastructure
WORKERS' COMPENSATION DECLARATION
I
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
. r,
t, ❑ Copy Is. filed with the city. . ❑ Certified copy is hereby furnished..
&
' .
TOTAL -•".; :-;. .l4-. - ...,ir`-s• .f'• fes.' ,
f CERTIFICATE OF EXEMPTION FROMa
' - WORKERS' COMPENSATION INSURANCE • •
i
'+
REMARKS ^ � i ' r-;i1_�y^ �"" '•�=+' �"� • • E �'i• ;a
• (This section need -not be completed if the permit is for one hundred dollars ($100) valuatronsrf,t-!^^f.(g'fDiF
rYs F w»
,'..:.:.et:-• t e '7
or less.) .. .. .
I certify that in the performanceof thg work for which this permit is issued, I shall .not
employ any person in any mannerso�as,to,.become subject to the Workers' Compensation
Laws of California
* y
Date Owner
-NOTICE
• TO APPLICANT- ft, after making this Certificate of Exemption you should become
ZONE: - . '- BY:
subjectto the Workers' Compensation provisions of the .Labor Code, you must forthwith
comply with such Provisions_ or this permit shall be deemed revoked.
Minimum_ Setback Distances:
FfOnt Setback from Center Line, '
Rear Setback from.Rear Prop. Line <
CONSTRUCTION LENDING AGENCY'
Side Street Line ` t
I hereby affirm that there is a construction lending agency for the performance of the
.Setback•from'Center
,
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property Line
Lenders Name
— . • ., .
Lenders, Address �.
}
FINAL DATE' INSPECTOR
This is a building permit when properly filled out, signed and validated,'and is subject to
expiration if work thereunder is suspended for 180 days: •
iI 1U/�� •' '
I certify that I have read this application and state that the above information is correct.
"agree
Issued by: Ddte Permit
I to comply with all city and county ordinances and state laws relating to building'
'
r i
construction, and hereby authorize• representatives -of' this city 'to enter the above•.
' mentioned property for inspection purposes.Val
ldated ,by: '
m Signature of applicant - Dater
Mailing Address '
„Validation:,
City, State,* zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SQ. FT. ® $
UNITS
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SQ. FT. ®
DUCT WORK
ROCK STORAGE
/y
FOUND. REINF.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
REINF. STEEL
GAS (FINAL) TEMP. POLE
POWER OUTLET
DRAINS
GAR. SQ. FT. ®
FINAL INSP.
IROOF
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SQ. Fr. ®
LUMBER GRA
FINAL INSP.Ftm O 4
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
G/� • " �% `M l/l L l[C�
00"d " I �V� ' / i/y gd J
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6DVENTILATION
URINAL
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
I
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
FINAL INSPECTION
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. Fr. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
INSPECTOR'S SIGNATURESIINITIALS
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
M=CH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
UND PLUMBIN //.ir 6 UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE `: gQ
ROUGH PLUMB BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWE XOR SE K ROUGH WIRING
DUCT WORK
ROCK STORAGE
/y
FOUND. REINF.
GAS (ROUGH) i Q METER LOOP
6
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 GRA
FINAL INSP.Ftm O 4
FRAMING / Q i
FINAL INSP.
ROOFING
G/� • " �% `M l/l L l[C�
00"d " I �V� ' / i/y gd J
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6DVENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL 9
LATHING
MESH
INSULATIONISOUND d,1 od
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL