15074 (PAT)Building
Address 79-595 Starflower
Owner'
aric Maxwell.
Mailing r
Address Sam
s.
4
P.O. BOX 1504 No. '15074
78-495 CALLE TAMPICO -
LA QUINTA, CALIFORNIA 92253
City
Zip
Tel.
La Winta, C8
92253
Repair ❑ Demolition ❑
Contractor ,
David Addington
Address ...
81-300 Ave. Ga into
' City
Indio, CA
Zip.
92201
Tel.:
. 347-6797
State Lic.
City
& Classif- .. 682901
Lic. # 3724
Arch., Engr.,
;Designer
Address
Tel.
City Zip State
. .. I . .. Lic. # '
LICENSED CONTRACTOR'S DECLARATION.
I hereby affigr that I am tfcensed under provisions of Chapter 9 (commencing with Section
7000) of Division/3 of the Business andYPr I -salons Code, and my license is in full force and
t,,pffect. "4
SIGNATURE" .d" DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, atter, Improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to rile.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 the basis,
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penafty of not more than rive hundred dollars ($500).
O 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 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 are not intended or offered for sale. If, however, the building
or Improvement is sold within one year of completion, the owner -builder will, have the burden
of proving that he did not build orsnprove 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's contraclor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
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. 3900; Labor Code.)
Policy No. Company
D Copy is filed with the city, ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ff the permit is for one hundred dollars ($100) valuation
or less!)
cerfity that in the performan8^gf thg work for which this permit is issued, I shall not
�Dal,
mpoy any person in anymsof�e 'a_Owner OTICETOPLubect to the Workers' Compensa0on provisions o/ the Labor Code, .you must forthwith
comply with such provisions or this penntt shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO:ONE.
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when property 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
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description ratite Cover
Sq. Ft.
Size 1:44
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Rear Setback from Rear Prop. Line F
Side Street Setback from Center Line
i
Side Setback from.Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
Estimated Valuation
$3.0915.00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
29.25
Const.
45.00
Mech.
Electrical '
Plumbing
S.M.I.
.19
Grading
Driveway Enc.
Infrastructure
TOTAL
74. 44
REMARKS
ZONE:
BY: '•1 s'
Minimum Setback
Distances: '✓'
Front Setback from Center Line
Rear Setback from Rear Prop. Line F
Side Street Setback from Center Line
i
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. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
'BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT. @
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
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
VENTILATION
LAUNDRYTRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
. SEWAGE DISPOSAL
SO.FT.GAR ® V/ c
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
'BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREWINITIALS
GARDEN WALL FINAL
t
r-
4ft•r Slag • tp•ciy II
2) DG •
Roof pitch--L►��C
�Cwotlo we Lodge
Mea r — ---
S at MAX 9PAN (� � Y sad Loaf. Strop
t-sa-al"alw Witt+ J
4-lt halls or bolt
softer Spee------ MkA - Feet spattna__iLvz
Overall lel:ati 2121--
' _ �?1�►►_N_ 5Mw .. .
Mia. 4"s4" haste
.� •�R�►R, P�•stoE
sea %WfLul Note aglow
-al+tlfr toafla4 / Sh•athlae at /)eo Lattice
.
�o
SE7�
�,• ��.:� ,„,.. t� u
,J L_.l
i—.1.,
1512•tle= 11'
�,/S":!” log scrt+a late sisda at la' •.e. WOW trade
Cmtlauaua lied er
I
�,Kif�j a 0 -strep or
F!r �tle
•acaor
' bolts
•`
Provide 1" .` it Mat+-carr«iw_•'
learanc '' Plate
ost To 6• • - .� II ���
Joist utter or Solid alecita= Concrete 1 1 1 1 •• .id'
Mail Ufter to lloctlnj / +I :. jilt
AIL C?.-V�>MM; 4 - It ! smile or belt
5-6. C .MP.•. 'M • ' . . • �L Crate ,- + .• Loll �� r
llltUWM M:131DD& Sabel •aelars Y in ease.
C T
4• 46• 1LA3M 1�ta%alb .
j�v
01
4 L �ougLs !it Mo. l
� " �1� �`�•
miss @WSCK • SPM•
>>s 20-10 ;R •Q� ,� ,
11
(feet a lachaa) Fs €- �+'� .
4>10. _ X14' • � v
>,Fy"� is
ALU y'Ji ts'
I'm
TZ
�-?=1a
t,
6-) •,,iP6
W 5Y }0.
117 10-0
12-
10-10;
_•
Zaet, l6-' o.c..•
;215
11-10 1'1' -lo
15-6 11-0
}i_'.,
16-1 12-1
` 12•
16-S
13-0 10-0 w
' 6fr-2
N."-- -
^� lald....... 26, VaM{ of
a• DWS tl
6.10..... ie' b t tc )•t'
Note
s. shakes 4112 pitch 11/12 si'k. pitsh W ---h 101
It Ws1de- lay) CLss A
etr-asisiW- e`_ -,Saes C-12 pitrr I3/12 tri..
td+ -th 151 felt vndr= lay) . Class q
C. It t.T rolled rho! 5!¢ to dra_..
d. [ rim, 1/11 w .•-i,• rj 2r -h_
gY 7YPICAL PNTW = R
Cu
F�7'?Q'SS
FC250 1., fr'1.57, r