9969 (SFD)P.O. BOX 1504 N o . 996.9
Building7&105 CALLE ESTADO
Addres78--910 La Palma Drive LA QUINTA, CALIFORNIA 92253
Owner
Williams Development tori)
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address 42600 Ca9ok St
City -Zip Tel.
Palm" Disert 92260 1 345-7541
Same as Above
Address
Zip ITel.:
State Lic. rte, City
& Classif. Bl Lic. #
tt..
' Arch., Engr.,
Designer Stcffregen Fuller
Address Tel.
31728 Rancho Vievo Rd 714/493-0660
City Zip State
San Juan Cap -s trano Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
�- 7000) of Division3.of the Business a d Professions Code, and my license is in full/force and
SIGNATURE ® 1' /' DATE
OWNER -BUILDER DECLARATION
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 constrict, atter, improve, demolish, or repair any structure, prior to its issuance also
requires theapplicant for such permit to file 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 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
subjects the applicant to a civil penaffy of not more than five hundred dollars.($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will
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 Improves thereon 'and who does such work himself or through his own employees,
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-bullder will have the burden
of proving that he did not build or Improve for the purpose of sale.)
0 I, as owner of the property, am exclusively contracting with licensed contractors to Con-
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
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
D 1 am exempt under Sec. r B. & P.C. for this reason '
Date Owner.
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
I0 Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit Is for one hundred dollars (8100) valuation
or less.)
I certify that in the performance of tho 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 t
Date Owner.
NOTICE TO APPLICANT: ff, ' after making this Certificate of 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.
CONSTRUCTION LENDING AGENCY
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.)
Lender's Name
Lender's Address
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.
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.
Signature of applicant Date I
Mailing Address
City, State, Zip
A.P. Number
Legal Description Lot 66 Tract 23269
Project Description Model #1C
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
�. F
4
Sq. Ft._
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter❑ Repair ❑ Demolition ❑
Permit does
not include
block walls or
►)001
Estimated Valuation
86,959.50
PERMIT
AMOUNT
Plan Chk.'Dep. ``'
250."00 -
Plan Chk. Bal.
255.26
Const.
594.50
Mech.
49.50
Electrical
827.25
Plumbing
144.00
S.M.I.
• 8..70
Grading
20.40
Driveway Enc.
20.00
Infrastructure
1956.89
,),
1ilf4�� %x 'ix#.!k,1.`: 1A�%�5:��
TOTAL
3426.10
317-6. 10
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
�. F
4
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES �6
r
1ST FL. SQ. FT. ® $
2ND FL. SO. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SO. FT. ®
SQ. FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
f
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ® c
BATH TUB
BOND BEAM
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ic
HOUSE SEWER
FRAMING , G11G�
FINAL INSP.
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
ROUND PLUMBING t� !
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEW
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
c$
LUMBER GR.
FINAL INSP.
FRAMING , G11G�
FINAL INSP.
ROOFING
1
n /
/
/�
� CiY
REMARKS:
VENTILATION
FIRE ZONE ROOFING ,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING z %e
MESH
INSULATIONISOUND l �LL q
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
"Me Ile 1 1 C
,Lo r
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Owner Wi 1l i ams Leve l opment
Contractor Same
Permit Number 9969
POST ON JOB INCONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOe ADDRESS 78910 La Palma Drive
Permit does not include block walls
or pool
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK ,
MAIN GROUND SYSTEM II
GROUND PLUMBING I I'liql
- Fq I / %i
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
'CONCRETE SLAB it ptLi/f
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
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP ' Lb
GROUT ❑ 4' ❑ 8'
FRAMING
PRE -ROOF I I
COVER NO WORK UNTIL ABOVE HA B EN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER S043GPIIANK / 77
PLUMBING
FINAL GAS TEST 2 -
HEATING - A/C
HOUSE NUMBERS
JOB COMPLETED
TCLAD 0!11NCD
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4!88