08970 (SFD)P.O. BOX 1504 N Q , 08974
Building 78-105 CALLE ESTADO i
Address 79-995 InAism wood court LA QUINTA, CALIFORNIA 92253
Owner
Mailing - BUILDING: TYPE CONST. OCC: GRP.
Address Q A.P. Number
City Zip Tel.
f►� Q Legal Description Rrnek 11kr1oost
Contractor Project Description W l '3tre! JAC' JAS
s 3
i4
Address
City Zip Tela
State Lic. City
4� Classif. 412636 Lic. # 133 Sq. Ft. No. No. Dw.
Arch., Engr., Size 2740 Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
4ddress Tel.
Dity Zip State
Lic. #
LICENSED`CONTRACTOR'S DECLARATION
I hereby affirm.that 1'am licensed under provisions of4Chapter 9 (commencing with Section
7000) of Division 3,of3tle Bufsin�ess and Professions�Code, and my license is in f/�f forcee and
effect. �./ �L�r��/ /.f _.��✓ff I d4v
'DATE _
�OWNER•B�J�LDEf�DECLARATION r' •
I hereby affirm that I am exempt fromsthe Contractors License Law for the following Estimated Valuation
uires a $200.357
'easbn: (Sec. 7031.5,Busfness and Pro/essions Cotle: Any city or county which req
1ellrllt to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
equires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT `
he provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
)iviston 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
or 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 five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
J. the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.
'rofessions Code: The Contractor's.Lfcense Law does not apply to an owner of property who
luilds or improves theieon and who does such work himself or through his own employees, Mech. 3.00
'
lrovfdad that such improvements are not intended or offered for sale. If, however, the.building
)r improvement is sold within one year of completion, the owner-builder will have the burden Electrical d proving that he did not build or improve for the purpose of sale.) -162 Af-
D 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
;truct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law 162.50
foes not, apply to an owner of property who builds or improves thereon, and who contracts for S;M,I: I ,
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 1A f17
]Tam exempt under Sec. B. 8 P.C. for this reason
Grading
Driveway Enc.
late owner. Infrastructure 4508.03
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
OwCopy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation (' ) $ ? ��'� f 3r,y �i i'•^fi "`' =7
or less.)
.X!J >;..$3r:i`i �
I certify that in the performance of the work for which this permit is issued, I shall not t f$}L 1 @o4y'+V6
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 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
Bork for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line
.ender's Name
.ender's Address
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
xpiration 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 Permit "
agree to comply with all city and county ordinances and state laws relating to building
on -t
and hereby authorize representatives -of this city to enter the above. o
7.ntioned property for inspection purposes. Validated by:
signature of applicant Date
Railing Address Validation:
:ity, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
GAS (ROUGH)
DRAINAGE PIPING
WALL SO. FT.
OTHER APPJEGUIP.
DRINKING FOUNTAIN.
SO FT ®
TEh1P. 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.COOL 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.
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Va c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® 3/ic
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE JPL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
� ROUND PLUMBI
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER O�_K -9
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEGUIP.
REINF. STEEL
GAS (FINAL)
TEh1P. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING - S
REMARKS.
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
MODEL 3C Lot 13 Unit 103
a
CITY OF LA OUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
. Owner M.J. BROCK
Contractor M. J. BROCK
Permit Number 08970
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS 78-985 Indian Wood Court
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL —
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT -A/C
BOND BEAM
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING Q
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGP6D
DRYWALL INTERIOR ol
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SPIZItCTANK—
FINALS
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
a �