05989 (SFD)P.O. BOX 1504 No., 059'89
s
BuildingJ —72g � �� � � 7&105 CALLE ESTADO
Address LA.QUINTA,.CALIFORNIA 92253
Owner,
Simi" Co.
BUILDING: TYPECONST.*_ . OCC: GRP.
Mailing .. t
Address, ,• . ' '
75-005 Co=try 'Club A.P. Number PGA
City Zip Tel
P.D l92260 56$=2€.18;._ • • • , Legal Description
CO^Of Project Description afro 1�A Pian ZQ
same
Address ~• n
City .. Zip Tet.:
` ' State Lic. " City
& Classif. $$23 3 Lic. # 328. , ...., a Sq. Ft.- No.- No. Dw. `'
��(�� C��fff.�ff�� Size 2272 - Stories 'Units'
( signer New X1 Add ❑ Alter ❑ Repair ❑ -Demolition ❑ , t
Address- Tel.
City Zip State _
Lic #
LICENSED CONTRACTOWS DECLARATION
I hereby affi® Ifmilt I an kicorsed under provisions of Chapter 9 (commencing with Section
7000 of Diuo®om3of Ow Bitasbness and Professions Code, and my license is in full force and
DATE J
..
^ I hoeb9r aM, Ii I �OrN9Ffrom the DECLARATION License Law for the followingEstimated Valuation GB8 p !�
reason (Sec 703x_ and Rafessiars Code: any city or county which requires - 158,646.0ci " � � t ,• •%
perrnN OD a 2 f gidi ice. demolish, or reps any structure, prior to its issuance also
names me foi In lie a signed statement that he is licensed pursuant to PERMIT AMOUNT
Ore proar- - aff me Cohacamdk Unser Las, Chapter 9 (commencing with Section 7000) of
3 of go amzf Fmollissbois of oti-�soyt�apa and the
Any Section7031.5exempttherefrom,
r apermit -Plan Chk. DepN... -
'sutlieirZsmeIli aam7pionallyof not more Man five hundred dollars (as00). 3n / •eZf -
El. 1. as oameref PIChk. Bal.
gmegmty, or my employees with wages as their sole compensation, will
do the work, and Igo structure is not intended or offered for sale. (Sec. 7044, • Buisness and -
Pholessims ( . T&e 's License Law does Trot apply to an owner of property who Const. •
I-afto.i�rrmres lV ansuch d aft does suwork himself or through his own. employees, Mech.
pmoaduted Itnffi;smuh - ave not Intended o offered for sale:, lf, however, the building
of mopI is std vurilifn am yea of completion, the owner-budder will have the burdenElectrlCdl
of..wAng.mwImdi�doftPib
aoverMeprryoseofsale.)- - - -
®kasa®neQa6thi ampsGusivelyconbactingwith licensed contractors tocon- Plumbing ��e •
street Dae ll fi I 65c 70". <bseress•and Hdessions Code:. The Contractor's License Law
dam not api lm as awomeir of prmpedy .circ bids or improves thereon, and who contracts for S.M.I. :11. .
such - 0 wilitm a mmatI I g i Pmevsedpu LmM to user Contractor's License Law.) _ -
® I as ezem I ' emmder roti a & P.C. for this reason Grading o
Driveway Enc.
case Ovm�r Infrastructure 3569.53
Less Credit 1784.77
WOMa3W COM4EMMInON DECLARATION infra Due 1784.77
1 hereby affmma that I hams a certificate of consent to self-insure, or a certificate of `
Wodiers Compensizi Insurance, air a certified copy thereof. (Sec. 3800, Labor Code.)
pofiry Na dory.
® Copy ist� ®iIh the city_ El Cerfi ied copy is hereby furnished. I
TOTAL
tEII[ITFICATEOFEumpnONFROM REMARKS. r
MOItI�COMPENSATIONINSURANCE u '•_r �: ` —� •�x nr».psV.,a.tye
' (chis semen nod aw he IT Ore pelnr7 is for one hundred dollars ($100) valuation L..x i+jly.rq k`r•I`'t,;'1 q ::1.1 cls it.x.°_ '
of lei
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any moaner so as to become subject to the Workers' Compensation
Laws of Ca6fac�'
�. ammbe
f aller mating Ihs CethWcafe of Exemption you should become " ZONE: BY:
sUllillisa RD 11W 111bulliEW. CrmpoRisallibn Provisions of the Labor Code, you must forthwith
qty NM arlillftper,Isriallbedeemed revoked. Minimum Setback Distances: A
Front Setback from Center Line
Rear Setback from Rear Prop. Line
COIISTHIICILON LENDING AGENCY. Side Street Setback from Center Line • f
hereby affeo® Dont noire is a construction lending agency for the performance of the - . tl 1, -
wait kfa•wB::htlus9 _ Hisiissmem (Sec. 3097. cdcode.) Side Setback from Property Line W1
Lendees
Lender's
FINAL DATE INSPECTOR
` Tuns s a bmuadarvg pammmit when properly filled out, signed and validated, and is subject to ,.
equation it work tl�erwdrr is suspended for 180 days.
6-!-19-89
1 certiry that I Ire rei this application and state that. the above. information is correct. Issued by: ' Date Permit
1 agree fo comply, womb an city and county ordinances and state laws relating- to building - - -
• ' oornstrmrdimq and fly amtbaime representatives of .this..city to enter. the above:
"'a'mtia'edprep®tyfmi Ctionputposes Validated by.-I,+
SiValpre, of Date
ung Validation:
Cft - stare, ro . l
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
R OR SE T
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
S (ROUGH) !
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SO. FT. ®
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
=$
L MBER GR.
FINAL INSP.
AMING
URINAL
SO. FT.
O � (��
�� (lio
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
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
SPARK ARRESTOR
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TR. FIREWALL
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
FINISH GRADING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
W.ECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
UND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
R OR SE T
ROUGH WIRING
DUCT WORK
ROCK STORAGE
ND. REINF.
S (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$
=$
L MBER GR.
FINAL INSP.
AMING
FINAL INSP.
ROOFING � /
O � (��
�� (lio
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
TR. FIREWALL
FANG � 3
MESH
S TION/SOUND f'Q i
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
1