001762 (RPL)P.O. BOX 1504 No. 001762,
Building 78-105 CALLE ESTADO
Address 44-266 E. S=dmm Ciea D. LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 1001 FAShop st.'suits 2700
City Zip Tel.
. .... ROMIUlu 92260 .340--5512-
Contractor
34 53.1•_Contractor
...Address.. . .
74.399 MW M'tom L
.. � City _ . Zip .. . Tel-.
� �J� 922 340-55.n
State Lic. City
& Classif;"2,822 Lic. # 237
• Arch:, Engr., _ .
Designer
Address Tel.
BUILDING:- TYPE,CONST.'• OCC: GRP.
A.P. Number 513-421-003
Legal Description 7kWt 199€33
Project Description pool '
Sq. Ft.' .• No. No. Dw.
Size ¢ Stories Units
New 0—I
Add ❑ Alter ❑. Repair ❑ Demolition ❑
City
"
State
]ZIP
Lic. #
., LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that Iam licensed underfDrovisions•of•Chapter 9 (commencing with Section
- 7000) of Division 3 of the Business and Professions,C/ode; and my license is in full -force and
effect.. .( l?� .;n!: 1'��"Oit�6�.s1
eE
DATE
.. .. .... -
1/ " OWNER;BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor s License Law for the following0
Code: Any
Estimated Valuation
.2.
• reason: (Sec.'7031.5, Business and Professions city or county which requires a
permit
permit to construct, alter, 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
'.'Division 3 of the Business and:Professions. Code, or that:-he'is exempt theiefrom,'andthe basis
for the alleged -exemption. Any violation—of 'Section 7031.5, by 'any applicant .for. a permit
-.Plan Chk: Dep. _ r
subjects the applicant to a'civil penalty of not more than five hundred dollars (8500):
Plan Chk. BBI.
• ❑ I, as owner of.the property, or my. employees with wages as their'sole compensation, will
6.o�iG
do the work, and the structure is not intended or of for sale. (Sec.' 7044, euisness and
Const. "�p,
• Y Professions Code: The, Contractor's License .Law does 'not apply to. an owner of property who
� JCS..-507l��4q
builds or improves thereon and who does such work himself or through his own employees,
M6ch.. •- - - ..
provided that, such, improvements are not intended or offered for sale.. If, however,. the. building
or -improvement is.sold, within oneyear of completion,•the, owner -builder. will have the burden.
'-EleCtrlCal
. of,proving, that he did not build or improve for 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. -so-
- such projects with •a contractors) licensed pursuant to the Contractor's License Law.)
-
Grading
11I am exempt under Sec. B. 8 P:C. for this reason
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby 'affirm that I 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.
TOTAL64.02
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: 11, 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 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 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 properly filled out, signed and validated, and is'subject to
expiration if work thereunder is suspended for 180 days:
I certify that I have read this
g—
' 25-
application and state that.the above information is correct.
I -agree
Issued by:. - Date Permit
to comply with'all city and -county ordinances and stale 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 applicanf i . rr _ i�sidr Date?
Mailing Address f
Validation:
city, State, Zip - +
A3021 1U 3.0
64,'L2 Ch
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO..=T. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ, FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUA71ON $
UNITS
MOBILEHOME SVC.
POWER OUTLET.
YARD SPKLR SYSTEM
BAR SINK
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.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
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 ® 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 -ANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESANITIALS.
GARDEN WALL FINAL