05439 (SFD)P.O. BOX 1504 NO. Q.5439
Building 78-105 CALLE ESTADO
Address 54-511 S6M d'PMLS LA QUINTA, CALIFORNIA 92253
Owner sUristYBUILDING-
Mailing �r : TYPE CONST. OCC: GRP.
Address 42-600 COM STS 200
A.P..Number
City Zip, Tela
. P DESERT 322513 568�2�32$.. , Legal Description GALL IES
ContractorRMONIAL _ Project Description M BI MAS9 M
Address
SM
City Zip Tel.:
State Lic. City
&Classif.Lic. # S Ft. No. No. Dw.
288130 Size 831 Stories Units
Arch., Engr.,.
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full fforce and
effect• .. ;...• 1 , f r r'
SIGNATURE r'o 'DATE
OWNER -BUILDER DECLARATION Estimated Valuation
1 hereby affirm that I am exempt from the Contractor's License law for the following 272,603
reason: (Sec. 7031.5,8&ssness and Professions Code: Any city or county which requires a
pernit to construct, after, knprove, demolish, or repair any structure• prior to its issuance also
requires the applicant for such permit to rde a signed statement that he is licensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with.Sectfon 7000) of
Diyision 3 of the 136smess and Professions Code, or that. he is exempt therefrom, and the basis q
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
subjects the applicant to a civilpenalty of not more than Ove hundred dollars ($500).i ,
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will . Plan Chk. Bal. 1 _
do the work, and the structure is not intended or offered for sale. (Sec. 7044, euisness and Const.
Professions Code: The Contractor's License Law does not apply to an owner of property who
budds or improves thereon and who does such work himself or through his own employees, Mech. — 1
01
provided that' such improvements are not intended or offered for sale. ff, however, the building _
or improvement is sold within one year of completion, the owner -builder will have the burden Electrical L
of proving that he did not build or krprove, for the purpose or sale.).
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing %
struct the project (Sec. 7044• Business and Professions Code: The Contractor's License Law
does not apply to an owner of properly who builds or improves thereon, and who contracts for S.M.I. •
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure �3x. _•
SS eR � 0•MIT
WORKERS' COMPENSATION DECLARATION Intra awe Ow
1 hereby affirm that 1 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. — —
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE ° 1^"`^ '•» '• " _
(This section need not be completed if the permit is for one hundred dollars ($100) valuation' ``x ``i,r: } '}I `=; �,. , •??�s �
or less.) .
certify that in the performance of thg work for which this permit is issued, I shall not
employ any ppeerson in any manner so as to become subject to the Workers' Compensation
Laws of California
Date -owner
N017CE
ateowner
NOTICE TO APPLICANT: n, after malmng this Certificate of Exemption you should become ZONE: BY:
subject to the workers' Compensation provisions of the Labor Code, you must forthwith
oomprywahSuch Provisions brthis Permit Shall bedeemed revoked. Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line
1 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.) Side Setback from Property Line
Lender's Name
Lenders Address FINAL DATE INSPECTOR
This is A building permit when properly filled out, signed and validated, and is subject to r
expiration if work thereunder is suspended for 180 days. '3/ 3/898
1 certify that I have read this application 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--
mentioned property for inspection purposes. Validated by:
i'
Signature of applicant Date
Mailing Address Validation:'
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
B GRADE 5-2f5:2ROUGH
41V 90
PLUMB.
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SQ. Fr. ®
HEATING (FINAL)
I
REINF. STEEL
GAS (FINAL),
DRAINAGE PIPING
CARP. SQ. F7. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL SQ. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SQ FT ®
GRADING
cu, yd.
$ —Plus—X$—=$
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSPa ] .9F
WATER PIPING
NOTE: Not to be used as property tax valuation
zVENTILATION
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
,wFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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
-4
S BACK
OUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
B GRADE 5-2f5:2ROUGH
41V 90
PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGE}{ -
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$—=$
LU ER GR.
FINAL INSPa ] .9F
MING ' t ?6-
FINAL INSP.
zVENTILATION
/�
/7 �✓
GJ //
REMARKS:
,wFING
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GA FIREWALL
RING
MESH
CATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
'
GARDEN WALL FINAL