14634 (SFD)44
P.O. BOX 1504
Building .78-495 CALLE TAMPICO
Address • 9' 175 : Xara Court LA QUINTA, CALIFORNIA 92253
Owner Celituiy Pomea. C,Cfmmunitleew
Mailing
Address .1535 Soti¢l. '!DO Streetir Ste. 200
City Zip Tel.
r€1 no, CA 9240.8 $9a9�.381�-60+�7
Contractor'
Address..
City JZip_ . Tel.'.
State Lic. #3 3 x.473 . City 222m
. & Classif..: Lic. # .
Arch.-,
er9r,1diYli ASa.ag Ss Assoc.'.
Avenue TI -7-14)359-6066
Cit Zip State'
>v8afep CXt+:
..92505-.-. Lica#.
s., LICENSED CONTRACTOR'SDECLARATION
I hereby, affirm that l am licensed under provisions of.Chapter 9 (commencing with. Section
91000) of Divisidh 3 of tfie.Business and Professions Code, andamy license is in,full,fforce.and
No. 14634
BUILDING: TYPE CONST: `� OCC: GRP.
A.P. Number
Legal Description LOQ 3Z Tract 26188 Phase .1.••
Project Description_- S?D Plan 4
Dee RP -y at L'a.:,Quinta Nort>:r
Sq. Ft. No:. No. Dw.
Size - 156.7 Stories Units .
New. ❑
Add ❑ - Alter ❑ Repair ❑
'Demolition:❑'
�LGNAT IRE'."__.x •:brr';'. ,.,>^':_ .,.rv.�'"' P : / DATE
.. .. .. ...
OWNER -BUILDER DECLARATION
f
I hereby affirm that) am exempt from the`Contractor's License Law for the following
. ,reason:- (Sec. 7031.5,Business.anii-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.
• the -provisions of,the Contractor's License Law, •Chapter -9 (commencing -with. Section •7000) of
'Division 3'o/ the. Business and-Professkms Code. or that. he is exampt•therefrom, and the basis'
' for the alleged 'exemption. Any violation, of Section 7031.5, by 'any- applicant fora permit
subjects the applicant to a civil penalty of hot more than rive hundred dollars ($500). .
❑ I, as owner of'the. property, or my.employees with wages as their sole,compensation,:wig
do the work, and the structure.is not Intended or offered for sale. (Sec. 7044, Buisness and
• 'Professions Code: The Contractor's License Law does not apply to, an owner,of property who
builds or Impro4es thereon and who does such work himself or through his own employees,
- ' provided that such iniproveinents.are.not Intended .or*offered'for.sate. -If, however,-the'building .
,.or improvement is sold within one year o/ completion, the. owner -builder will have the burden
.of proving. that he,did not build or knprove for the purpose of sale.) .
Estimated Valuation 9.7;p; �3 0
•
t
..:PERMIT .AMOUNT
- - -
- -
Plan Chk. Dep. ,” .- 250.•.00, ',
Plan,Chk. Bal. — 2$ 33
Const. .� ' S:{�
-
Mecfl:, .$ 7 O
Electrical 1 3 0 • 59
Plumbing
O'I, as owner of the property, am exclusively contracting with licensed contractors to con- .
'-struet the -projects (Sec. 7044, Business and Professions Code: -The Contractor's.License Law,
. does 'not .ry /o an, owner o/ property who'builds or improves. thereon„ and who contracts, for.
suchpro%ects wlth'a contractor(s) licensed pursuant to the Contractor's. License Law.)
' ❑ I'am exempt under Sec. - B. 8 P.C. for -this reason -
S.M.I.. - - 9 • 71. -.
'
Grading 20.00
;
Driveway Enc.
Date 'owner
Infrastructure.+:.$ .
., WORKERS' COMPENSATION DECLARATION
I hereb ' affirm that I have a certificate of consent to self -insure, .oi a.certificate of
Worker',,,,sr�C`ompensation.lnsurance, or a certified copy-thereof:.(Sec: 3900; Labor.Code.)
Po
a¢l l �c1N o. .Com parry
- -
"O.Copy is filed with.the city.. ❑ Certified copy is hereby furnished..
TOTAL .3 7.23:00 3,473.40' ..
CERTIFICATE OF EXEMPTION FROM
COMPENSATION- INSURANCE, .
REMARKS-
- -
(Thissection need 'nol,be.completed .If the,permit is for -one -hundred dollars .($ 100), valuation.
.. or less.) ' -
I certify that in the.perfornwnce 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:',g, ager making' this. Certificate ol•Exemption� you -should. become
subject' to the' Workers' Compensation provisions of 'the Labor Code, you 'must forthwith
comply with such provisions or this permit shall be deemed revoked - - -
,ZONE: BY: '
-
Minimum Setback Distances: - - -
'
Front Setback from Center Line
”
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS'.COMPENSATION COVERAGE IS UNLAWFUL,•AND' -.
SHALL SUBJECT AN 'EMPLOYER to CRIMINAL' PENALTIES AND CIVIL: FINES UP TO ONE .
Side Street Setback frenter Line
.HUNDRED THOUSAND DOLLARS.(3100.000), IN ADDITION.TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR IN -SECTION 3706 OF THE LABOR CODE. INTEREST, --ANO' .
ATTORNEY'S FEES. :. .. ..
' This is `a building p'ei n f when properly filled•out, signed and validated, and is subject to.
expiration if work thereunder is suspended for 160 days.
Lcer.I that.l,have read this. application and state'that.the' above information is correct
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.' '
Slde Setback from •P y. LI
FINAL DATE IN T•OII a .
Issued, by Date mit
1
Validated by: � O 1
Signature of applicant Date
..,Mailing Address
Validation: .
City, State, Zip
CONSTRUCTION ESTIMATE
, NO. ELECTRICAL FEES
NO. PLUMBINU FEES .
IST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. SO. FT.
WALL, SO. FT.
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)/ G
V /
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIR
LAUNDRY TRAY
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
AMPERES4SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB.
FRAMING(
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
REMARKS:
SO.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 I {ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING 1
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
'HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEP C
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)/ G
V /
METER LOOP
HEATING (FINAL),
OTHER APPJEOUIR
REINF. STEEL
GAS (FINAL) '
TEMP. POLE
.GROUT
WATER HEATE
SERVICE
FINALINSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
FINAL INSP.
GRADING
-cu.yd.
$ plus ' x$
_$
LUMBER GR.
FRAMING(
ROOFINGq1
O �/ r�
5-/6/Vw'
5-�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING I f(I1Xj
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
.FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL