05987 (SFD)44Q
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-585 Southarn Hills LA QUINTA, CALIFORNIA 92253
malnng
Address 75-005 Ca=try Club
CityZip Tel.
P.D. 922 502 568
Contractor
.. Address
city
State•Lic. City
Bf Classif_ 288130 Lic. # 328
Arch. -.-gr
Designer M
Address
Tel.
Y Zip State
Lid. #
UCENSED CONTRACTOR'S DECLARATION
1�q afrT->f� Dam r under provisions of Chapter 9 (commencing with Section
e ffecL r vfsmm3af theStashnessand Professions Code, and my license is in full force and
effecfL ><
SGNATUIRE DATE
„
OWNER -BUILDER DECLARATION
1 hereby attotrm tGah D am exempt from the Contractor's License Law for the following
nes= 0o=:'7a3V.5Jftshsss and Plrofessions Code: Any city or county which requires a
penm8' to c=sWAM alter, &;prove. demofsh. or repair any structure, parlor to its issuance also
rem " app8®C tfm seals permit to fie a signed statement that he is licensed pursuant to
Me prousfcas or Me lis license Law, Chapter 9 (commencing with Section 7000) of
Dhfsbm 3 os ate Bllusilness and Prefessons Code, or that. he is exempt therefrom, and the basis
6a Me alleged exempff m Any viatitian of Section 7031.5 by any applicant for a permit
suloaats Me a= fir nm a cAdpenaW of not more than rive hundred dollars ($500).
ED k as mwrnaof erre papenty, or my employees with wages as their sole compensation, will
do the weolk, and Me structure is not intended or offered for sale. (Sec. 7044, Buisness and
P67Dlessbus Q Me leo MzcMWs License Law does not apply to an owner of property who
hunts or Guprmues Meremn aad who does such work himself or through his own employees,
prmvi�d 9W sac& imp are not intended or offered for sale. If, however, the building
a.iroproveaecaa L4 smAd wt'Otirr me year of oonplebmn, the owner -builder will have the burden
bB paoerrg g.lat ne did nmft fbB a rznprove fa the purpose of sale.)
® 4 as aamw off the {pra perty, am exclusively contracting with licensed contractors to con-
struct tare pratjecL OR -='7044, Business and Rofessions Code: The Contractor's License Law
dbzes mW apply tm am owner at prbpcMy who builds or unproven thereon, and who contracts for
sada prarje= wife a (inJi licensed pursuant to the Contractor's License Law.)
m 1 am exerW urrdlEr Sec ------R & P -C. for this reason
Ila[e owra�
WORKEW COMPENSATION DECLARATION
her ehy aftraum that I have a certificate of consent to self -insure, or a certificate of
WiarkeRs Cmupensaftn Unrsrnance, ora certified copy thereof. (Sec. 3800, Labor Code.)
Pmrrcy K0,—Company
® Cmpy isfifta1 w2h the city- 0 Certified copy is hereby furnished.
CERRFBCATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
section creed nwr be emceed If the permit is for one hundred dollars (5100) valuation
I cediffy thaft in Me performance of"work for which this permit is issued, 1 shall not
employ �a fin any so as to become subject to the Workers' Compensation
Laws Date
NONCE TO APPRI41 Y 0 ala mrabimg this Certificate of Exemption you should become
subQect fm ate Zbft a Co¢POs3tim provisions of the labor Code, you must forthwith
cozwv MUM srxrlo p m4da s or the permit 990 be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 Iomeby affff m Mar flrere is a construction lending agency for the performance of the
work for wI this a is i=wd (Sec- 3097, Civil Code.)
Lendeis Narrre
Lenders Adm�s
This is a brddffiaog peQm-1 who properly filled out, signed and validated, and is subject to
espka!iior it work Onemaxrtda is suspended for 180 days.
I artily uw I Iraae read this application and state that the above information is correct..
I agree to cOMly with alb cdy and county ordinances and state laws relating -to building
con�4 and hereby authors representatives -of this city to enter the above-.
rrlerltlooeed I>aimly fw inspection Purposes.
Signature off ma Date
. Ming Address
cry. Slane, mar
No.
05887
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number PGA West
Legal Description
Project Description Pita M 19B MW EW
Sq. Ft. 2252. No. No. Dw.
Size Stories Units
New$d Add ❑ Alter ❑ Repair ❑ Demolition ❑
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center.Line
Estimated Valuation
158,646.00
Side Street Setback from Center Line
PERMIT
Side Setback from Property Line
AMOUNT
Plan Chk. Dep.
INSPECTOR
Issued by:
Plan Chk. Bal.
Validated by:
04. 27
Const.
Validation:
0at:T • Vu
Mech.
82.50
Electrical
73. .
Plumbing
S.M.I.
x •
Grading
Driveway Enc.
Infrastructure
3x3 •_
i
MRS halt
� EY .
ac-ra We
1784.7
TOTAL
�� J.C�
_1 Al/ /W
REMARKS
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
1ST FL. SO. FT. ® $
UNITS
LAB GRADE
ROUGH PLUMB.
44
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTI
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
S (ROUGH)J Z
AS(ROUGH)LIZ,
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. @
FINAL INSP.
BOND BEAM
WATER SYSTEM
DRINKING FOUNTAIN.
WALL SQ. FT.
=$
LUMBER GR.
FINAL INSP/,•/2�
FRAMING 1,012-14k-7FINAL
URINAL
SO FT ®
O� Qj�
Z��
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
I
I WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAR. 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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
,a
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACKOUND
PLUMBING d%
UNDERGROUND
A.C. UNIT
COLL. AREA
LAB GRADE
ROUGH PLUMB.
44
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTI
ROUGH WIRING
DUCT WORK
ROCK STORAGE
/ r D. REINF.
S (ROUGH)J Z
AS(ROUGH)LIZ,
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
r.
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/,•/2�
FRAMING 1,012-14k-7FINAL
INSP.
ROOFING /
l
O� Qj�
Z��
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
N to
MESH
INSULATION/SOUND 1 3
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
t
Z
�(�';l' .. _ ,,. •,t a. K Page' �� • Jof xJ�_
: x : DAVE � STEA - tNS'-, t A
Inspection Services {.;
PROJECT-&AtJ51"Gt >Jc� _ . PROJECTyCz 3
1_
ADDRESSS4� :SSG 'i Sg :g 6oS. �, t •'r CLIENT
ds Q+A+A. �.t { S e ?ZAJ Is- DATE A 0 M 4 X V. wa I c76 3
BLDG. PERMIT # ARCHITECT (�aG A ' A WC K ,
ENGINEER � J S' J�3 �1 c CONTRAq OR L r'f?p.? PA c r<
INSPECTION TYPE S
INSPECTION REI�61k': r
CERTIFICATION,OF'COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted;
=.�substantial) complies y' approved'plans, specifications and'applicable sections ofthe building codes. This report covers... ;t
the loca i e?`�r��k�insPected only and does not constitute engineering opinion or project control.,
CERT. NO.
T INSPECTOR NAME _ .J �1� ✓r ,c.i`'4
(Print Mont
DATE CQ, OV ;7,o a_3 - INSPECTOR SIGNATUR�r- ' Yl.
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At - 34 :,
CERTIFICATION,OF'COMPLIANCE: To the best of our knowledge, all of the reported work, unless otherwise noted;
=.�substantial) complies y' approved'plans, specifications and'applicable sections ofthe building codes. This report covers... ;t
the loca i e?`�r��k�insPected only and does not constitute engineering opinion or project control.,
CERT. NO.
T INSPECTOR NAME _ .J �1� ✓r ,c.i`'4
(Print Mont
DATE CQ, OV ;7,o a_3 - INSPECTOR SIGNATUR�r- ' Yl.
C