001759 (RPL)44
P.O. BOX 1504 N.O. 001'759
Building ' 78-105 CALLE ESTADO
Address 44-M Its sib crent Drive LA QUINTA, CALIFORNIA 92253
Owner
Gmv=1 Haragmw Omp.
Mailing. BUILDING: -TYPE CONST. OCG: GRP.
.
Address 1001 ft. &Atd 2700 A.P. Number 613-4U--003
City Zip Tel. - - - _..... .. ,
�f33Ui ��.3 Legal Description, ` �9�i.
Contractor Project Description Tbol -Sbada CbVor
Address....- . ..
City .. Zip _ Tel.. .
t 9226€ 340 -SSM
State Lic. City
& Classif. Lic. #
Sq. Ft.. No. No. Dw.
442R22 Zai Size .2.6Stories •
:. Arch.; Engr., nes .. Units
n
Designer. New.[ Add ❑ Alter ❑. Repair ❑ . Demolition ❑.
Address Tel.
City' Zip State
_ Lic: # ..
LICENSED CONTRACTOR'S DECLARATION..
I hereby affirm that.1 am licensed.under provisions of Chapter'9 (commencing -with Section
7000) of Division 3 of the Business and,P.roo ession uodre;.and my license is in full force and
effect. x
• SIGNATURE ,/ tom' � 9+.../' Lf DATE .. .. .. .. ... , ... .....
N%
OWNER -BUILDER DECLARATIO
e Estimated Valuation
I hereby affirm that I am exempt from the Contractor's license Law for the following
reason: (Sec. 7031.5,Business and Professions. Code: Any city. or county which. requires a
permit 'to construct,' alter, improve, demolish, or repair any structure, prior to its.issuance also.
requires the applicant for -such permit to rile 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 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 penalty of not more•than' ive�.hundred dollars (5500). • ' ' . . .
❑ I, as -owner of the property,. or my. employees with wages as their sole compensation; will Plan Chk..681. 25 . n2.
do the work, and the structure is not intended orofiered for sale: (Sec. 7044; Buisness and- Const.
Professions Code: The Contractor's License Law does., not apply' to, an owner or. property who
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 one year of completion, the owner -builder will have. the burden Electrical
of proving that he. did not build. or improve for the purpose of, sale.) - - _- . •*
O 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 whobuilds or improves thereon;, and, who contracts for S.M.L.-
• such projects with a contractors) 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
Ihereby affirm'that I have 'a certificate' of consent to self -insure, ora certificate of'.'
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No' Company .. .. .. ..
❑ Copy is filed with the city... O Certified copy is hereby furnished.
TOTAL 64.2
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.)
certify that in the performance of the 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 of. Exemption - you should - become ZONE: - BY: -
subject to' the 'Workers' Compensation provisions of-'the'Lbb& Code, you must forthwith
comply Setback Distances:
comply with such provisions or this permit shall be deemed revoked. - `
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 Prop-erty.Llne
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 application and state that the above information is correct: Issued by: Date 10'•-2513ermit
agree to comply with all city and. county ordinances and state laws relating to building .
TA-tyl
construction, and hereby. authorize representatives -of"-this,' city to enter-. the above
mentioned property for inspection purposes. Validated by:.
' Signature of applicant / iA /CY.. [1��Ate. ! Date
.Mailing Address 1 Validation:
City, State, Zip ' 7 a♦
( i _A3OZ3_ l.U, 30 64; L"2 Ck
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SQ. FT.
OTHER APP.IEQUIP.
DRINKING FOUNTAIN
SQ FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
I 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
GAR. FIREWALL
SO.FT.GAR Q 3/ac
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
IMECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. 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::::�