001760 (RPL)P.O. BOX 1504
Building .78-105 CALLE ESTADO
Address 44-250 E. SuindMM'CreSt. Dr. LA QUINTA, CALIFORNIA 92253
Owner
No:.
.001760
— - ' " "'
BUILDING: TYPE CONST. -OCC. GRP.
' Mailing. . _. .
Address .1001 St. ttQ 2700
A.P. Number
614--421-003
City
Zip
Tel.
Tmct 199903
Kwa_ Ulu
96813
Legal Description.
Contractor
Project Description
.Address.. .
74®399 Boy M Mitte L.. ..
_
..City. ..., .. - .
p. ._... .:
Zi.
Tela
Zahn DeSert
92260
34 5U.
State Lic.
City
. & Classif.... ��
Lic. # ��
Sq. Ft.
No. No. Dw.
.. Arch., Engr: ...
Size -�"
Stories Units
•' Designer .
New Q Add ❑ Alter ❑ Repair.0. Demolition ❑
Address
Tel.
_
City
State
_.
JZip
Lic. #
LICENSED CONTRACTOR'S DECLARATION ,
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 force and
'
effect. e -'?i .. A! l//�/i?F.
...
.. - -
SIGNATURE ^c.._J'•i v rec- 6' % - r_y r•,..� :.Yr DATE
..
OWNER-BUILDER-DEdURATION
Estimated Valuation
_ I'hereby;affirm that I am exempt from the Contractor's License Lawfor,the. following
• reason: (Sec. 7031.5,Business and, Professions Code: Any,city or _county which requires a-,
permifz,to construct, alter, "improve, demolish, or repair any structure, prior to its issuance also
,.,requires the applicant: for such•perrhit to file 'a signed statement that. he is licensed pursuant to
• '
- PERMIT
- •'
'- AMOUNT` '
the. provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of.
'Division 3 o/ the Business and'Professions'Code, of that. he is exempt -therefrom, and the basis -
for the. Any Section 7031.5 by 'any for
Plan'Chk. Dep. --
.
alleged exemption. violation of applicant a permit .•
subjects'the applicant to a civil penalty ofnot more than five hundred dollais.($500):"
Plan. Chk. Bal.
.
. ❑ I, as ow of the.properfy; or my employees with wages as their sole compensation, will ,;
work,
_ do the ork, and the structure is not intended or offeired.for sale. (Sec."7044, Buisness and
'
Const..39.50'
- Professions Code: The Contractor's License Law does not apply. to an owner o/ property who
builds or improves thereon and who does such work: himself or through. his own. employees,."
Mech.
-
provided that such improvements are-noi 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. -
'Electrical
. .of proving -that he did not build or improve /or.the purpose of 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 property who builds or improves, thereon, and who contracts for
S. M.I'. •• ..
�ia3l '
such projects with a contractor(s) licensed pursuant to the Contractor's License Law:)
Grading
,. ❑ 1 am exempt under.Sec.. . B. & P.C. for this reason -
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
i_" I hereby affirm that'l 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
O Copy is,filed.with the city, ❑ Certified copy is hereby furnished.
TOTAL
64.02
_
" CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE . .
(This section need not be completed if the permit is for one, hundred dollars ($100) valuation
-
.... or less:) .. .... - . . . _ . .
..
I certify that in the performance of tha work for which this permit is issued, I shall not
• employ any person in any manner so as to become subject -to the Workers' Compensation
Laws of California.
Date` 'owner
NOTICE TO APPLICANT: If, after making this Certificate o/ Exemption ption you should become -
ZONE:
BY:
" 'subject to . the" Workers' Compensation provisions of 'the Labor' Code, 'you must forthwith
comply with such provisions or this permit shall be deemed revoked. -
.
Minimum Setback Distances:. -
Front.Setback from Center. Line
'
Rear Setback from Rear Prop. Line
" CONSTRUCTION LENDING AGENCY. ,
Side Street Setback.ffom 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 properly filled out, signed and validated, and is'subject to
expiration it work thereunder is suspended for 180 days.' _
I certify that I have read this application and state that'the'above information "is correct.
'city
Issued by:
4� A.�
2..
Date • 0- -81.7, P e r m I t
I agree to comply with all 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. �� ��yy;d ,a
�x
Validated by:
Signature of applicant•* ,-11/ t /( _Ky& 11 Date
Mailing Address f ''d v ' 'vl f -
,Validation:
City, State, Zip J y
A 3 0 Z 4
J 0 3•_0
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
2ND FL. SQ. FT.
POR. SQ. FT. @
GAR. SQ, FT. @
CARP. SQ. FT. @
WALL SQ. FT. @
SQ. FT. @
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
I ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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.
SQ. FT; RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
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 APP.IEQUIP.
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
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL