06825 (SFD)P.O. BOX 1504 N o .
Addrdess 44-210 %reetbush Large LA QUINTA CAL FORNIA 92253
La Quirtta Associates
Mailing
Address 43-875 Washinoton St.
City Zip Tel.
Palm peseri • . 92260 1 . 345-7541
Contractor
-E.G. Williams DeY. Care.
Address .
Saar
Tel.:
State Lic. I City
& Classif. 493919 Lic. # 1231
Arch.; Engr.,
Designer
06825.
BUILDING: TYPE CONST. � a OCC: GRP.-
A.P. Number Tract 22982 Phase IV
Legal Description Cactus Flower
Project Description;ao 3S ��'
Sq. Ft.
Size
New ❑
No. No. Dw.
1533 Stories Units
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
bivision 3 of the Business and Professions Code,
f
and my license is in full force and
effect
effect.
Y
SIGNATURE DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following.
Estimated Valuation
x
reason: (Sec. 7031.5,&mmess and Professions Code: Any city or county which requires a
$86,825
permit to construct, after, enprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to ne a signed statement that he is licensed pursuant to
PERMIT
- -AMOUNT
Me proeLtiorns of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
Qvisnon 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the Any Section 7031.5 by 'any for
Plan Chk. Dep.
,
`
alleged exemption. violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
-
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
J
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Const.
� ril4 AA
581 00
Professions Code: The Contractor's License Law does not property
apply to an owner ofwho
sp
builds or irm%= thereon and who does such work himself or through his own employees.
Mech., •_
e
provided fhaf improvements are not intended or offered for sale. If, however, the building
or improvement is said wither one year of completion, the owner -budder will have the burden
Electrical�.
•
J3 J�
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of proving that he did not build or enprove for the purpose of sale.)
-
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
lzu.bu
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
S.M.I.
-
'
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
,
❑ I am exempt under Sec B. 8 P.C. for this reason
rr.
Driveway Enc.
-J h rr (3
Date �? =d� f owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I. hereby affirm that I' have a. certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
❑ Copy is filed with the city. ❑ Certified.copy is hereby furnished.
TOTAL
l+ _ .JiffI 5Z t "7. /e
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 the 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: 8, after malting - this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply wfth such provisions or this permit shall be deemed revoked. '
CONSTRUCTION LENDING AGENCY
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, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
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
IIlw
REMARKS kSA04rOff 6.f_1 `: A4A .{,7..�e'V;.. "� .... _
3.t).,"7CfIStj .1 tVIHL 3, :,='f'7•..1.;.r F
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 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SQ. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF.3 /5 Y�
r
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
REINF. STEEL
GAS (FINAL) r TEMP. POLE
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRAINAGE PIPING
CAR P. SQ. FT. ®
LUMBER GR.
FINAL INSP. 6 L
WALL SQ. FT.
FINAL INSP. 2 a'
DRINKING FOUNTAIN.
�•
/
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAR. FIREWALL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LATHING r jhf-' ( g�
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FENCE FINAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GARDEN WALL FINAL
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
JrFOUND PLUMBIN(a� % UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 31'2, �.
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.3 /5 Y�
r
GAS (ROUGH) -7 (0 ETER LOOP
(
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL) r TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FINAL INSP. 6 L
FRAMING s 9��
FINAL INSP. 2 a'
ROOFING 5N: 9e a
VENTILATION
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/
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING r jhf-' ( g�
MESH
INSULATIONISOUND �j
FINISH GRADING
FINAL INSPECTION S Aq al
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURBSIINITIALS
GARDEN WALL FINAL