05423 (SFD)` P.O. BOX 1504
No. 05423
' Building 78-105 CALLE ESTADO
Address 54-147 'Sgt IMN RMLS LA QUINTA, CALIFORNIA 92253
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Owner SUMSE CCS'
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BUILDING: TYPE CONST: OCC: GRP
Mailing �.
Address 422 -60 'CWK STRMI STS 200
• A.P. Number • •
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CityGAL( Zip Tel..
3f;,A$.�.LESS 922�i2A
Legal Description.
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MISS +
Contractor -;.
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Project Description
sit PHASE 1E
NA` 10 MOR G
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SIM t
.Address
SQA
- . -
City Zip Tel.:
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State Lia- -
288130
City
1
' & Classif-
Lic. # .1..208 <• 1 .. _.,
Sq. Ft.
No. r t No: Dw. • ' S
Size 3355
,
Stories Units `
Arch., Engr.,
' Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition p'
Address:'_
Tel.
City
Zip .
State
of
;
Lic. #
' LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7(100) of Division 3 of the Business and Professions Code, and mylicense is in full force and
effect.o%- .�..
' � �} • 41
SIGNATURE— DATE
' OWNEWBUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractors License Law for the following
7031.5,6usiress Code: Any
2�� a165
reason: fSec.' and Professions city or county,which requires a
permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also
-
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
PERMIT'
�AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
•i
` 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
-
Plan Chk. Dep.
-
subjects the applicant to a civil penally of not more than five hundred dollars ($500).
Plan Chk. Bal..
= 929
❑ 1„as owner of the property, or my employees with wages as their sole compensation, will .
Const.
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•
McCh.
'� •. ' ,'� - ��
• 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
Electrical '. '�, 1
�`�184.17
or irtprovement is sold within one year of completion, the owner-buflder 'will have'the burden
of proving that he did not build or improve for the purpose of sale.)
Plumbing
55
❑ 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 to builds improves thereon,
not apply an owner or property who or andwho contracts for
• • 'such projects with a contractor(s) 8censed pursuant to the Contractor's License Law.) -
S.M,j,
Grading
• O 1 am exempt under Sec B. & P.C. for this reason
Driveway Enc.
i
Dateowner
Infrastructure
5,4-71.22 :)' _•
ESS. IT
lzii,735.611
WORKERS' COMPENSATION DECLARATION
INM Da ”
p7 35♦iPi
- I her affirm that I have a certificate of consent to self-insure, or a certificate of
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Worker's Compensation Insurance, or a certified copy thereof. (Sec: 3800, Labor Code.)
Policy No. Company ,
O Copy is filed with the city. O Certified copy is hereby furnished.
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'TOTAL .
ZP1r *h&
CERTIFICATE OF EXEMPTION FROM
REMARKS:
5
WORKERS' COMPENSATION INSURANCE
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(This section need not be completed if the permit is for one hundred dollars (S 100) valuation'•
• or less:) .
" ..
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in many manner so'as to become subject to the Workers' Compensation
_
Laws of California nt:
Date_" Owner
NOTICE TO APPLICANT. If, after making this" Certificate of Exemption you should become •
'ZONE: -
BY:
' subject to the Workers' Compensation provisions of the Labor -Code,' you must forthwith
Comply with such provisions orthis 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
I 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
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when propedy.filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
/
S/,fie 89•
I 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: `
Signature of applicant a r Date'
Mailing, Address
Validation:
City,. State,
12 CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE Jj
Ag
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
ND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
-1
GAS (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL Sp. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
SQ FT ®
GRADING
cu. yd.
plus x$
=$
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FING
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
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. SOLAR
SETBACK
OUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE Jj
Ag
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
ND. REINF.
-
ROUGH)rl 11
/ s
METER METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
-1
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR. j
FINAL INSP.
1 G
FINAL INSP/`,o _
O� v
FING
!
lw/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
ARK ARRESTOR
LL
LATHING
MESH
ULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUREWINITIALS
GARDEN WALL FINAL
t