06856 (SFD)P.O. BOX 1504' N o . �'6-56,8
Building 78-105 CALLE ESTADO
Address 44-185 Swetbush Lane LA QUINTA; CALIFORNIA 92253
Owner `
La QUinta' Associates ,
BUILDING.- TYPE CONST. _- OCC: GRP...
Mailing : Tract 22982 Phase
Address � ���-83rd ��c�+��g��� ,$�� t A.P. Number _
City. _ Zip Tel. � � 'r
Palm. D6ser 92260 345-7541 Legal Description ����ii$' Fit >i"
Contractor Project Description' Plin OR " Lot 120
EAL Nii?.iams Dev.. Corp.
Address
-Same
City Zip Tel.:
State Lic. City
& Classif. 493919. Lic. # 1231
.Arch .; Engr.,
Designer,
Address' Tel.
Sq. Ft. No.
No. No. Dw.
Size Stories Units <
New ❑ - Add O Alter ❑ Repair O Demolition O
city Zip State
Lic. #
z
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
A700p) 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 I am exempt from the Contractors License Law for the following . Estimated Valuation $98.754.67
+ 8 *� 7
reason: • Sec. - 7031.5,Business and Professions Code: An cit or coup which r �'" ti 0� • �"
( Y � Y county squires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also • -
• reouires the applicant for such permit to Me a signed statement that he is licensed pursuant to PERMIT , -
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of - -
- Dfvisiod 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
•for the alleged exemption. Any violation. of Section .7031.5 by 'any applicant for a permit
subjects fhe applicant to a civil penalty of not more than rive hundred dollars (S500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
,r .do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: file 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 such improvements aro not Intended or offered for sale. If, however, the building
i� orimprovement is sold within 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) 8censed pursuant to the Contractor's License Law.),
❑ 1 am exempt under Sec B&-P.C: for this reason f . !
11'A
Plan Chk. Dep.
-t
Plan Chk. Bal.
Const.. 1
Mech.
- _
Electrical
Plumbing
S.M.1.
Grading
Driveway Enc.
Date x/'1711 Owner k > _ � .. r'.,K:;v�e y.-*. e � i �+
f
Infrastructure
WORKERS' COMPENSATION DECLARATION
1 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.
'
Laws of California
TOTAL
AMOUNT
! :,4 .494t.
5°o,
•53.
.:113:
.li- .�23•
• CERTIFICATE OF EXEMPTIONFROM
WORKERS' COMPENSATION INSURANCE
REMARKS
^•d i`. e�a�
(This section need not be completed N Me permit is for one hundred dollars ($100) valuation
�1
. 10`� 1`140 , r��.t k ..r +, �•y6.��:'?.U4
• 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
u
Date Owner
.
NOTICE TO APPLICANT. ff. after making this Certificate o1 Exemption you should become
BY: t -
subject to the Workers' Compensation provisions of the Labor Code,you must forthwith
compywithsuchprovisionsorthisPermitshall be deemed revoked..- _ •- ,.
,ZONE:
-
Min_irb6m'S etback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line'
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097,.CWCode.)
Side Setback, from Property•Llne'•1
Lender's Name
Lenders Address
FINAL DATE
INSPECTOR-a '
Thisy
is a building
g permit when properly filled out, signed and validated, and is to
expiration if work thereunder is suspended for 180 days. ;
i i d 9
i/ i��s
I certify that Lhave read this applicalion 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.
di
mentioned property torn purposes t',
Validated by:
Signature of applicant Date'
. ' it
Mailing Address '
Validation:
' City,. State, Zip
.... .,.. .. ....
•.
-._. --�
�,�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL SO. FT. ® $
UNITS
COLL AREA
SLAB GRADE3a
Ui
YARD SPKLR SYSTEM
2ND FL SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
q
FOUND. REINIF 90 /
1�
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P.. SQ. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL SQ. FT.
BOND BEAM
WATER SYSTEM
URINAL
SQ. FT.
,
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FRAMING
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
REMARKS:
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
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.
SO. FT. RESID ® 1+/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/4c
HOUSE SEWER
FINAL INSPECTIONS A 1
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
GROUND PLUMBING
NDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE3a
Ui
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANKl�
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
q
FOUND. REINIF 90 /
1�
GAS (ROUGH)- �( �U /�iO L
Y
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. talcto (�
FRAMING
FINAL =INSP-
2q
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTIONS A 1
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURE SIINITIALS
GARDEN WALL FINAL