9971 (SFD)Building
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Owner .
Williams Development Corp
Mailing
Address 42600 Cook St.
Cityp Tel.
�'92260
Paim Desert 1345-7541
Contractor
Address.
City Zip T
State Lic. City
& Classif. B1 19 -fir 3 9/q Lic. #
Arch., Engr., •
Designer Staffregert'uAler
Address Tel.
31728 rancho ViSJO.Rd 714/493-0660
City Zip State
San Juan Capi I ►trano Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3.of,the Business and P,rofessigns Code, and my licenseej in ull force and
effect /r_✓..�,� r' f%/`71
SIGNATURE—' '= �•-�- .. ./ / / 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 construct, after, Improve, demolish, or repair any, structure, prfor to its issuance also'
requiresthe applicant for such permit to Ole a signed statement that he is -licensed pursuant to
•i' 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'Sectiom 7031.5 by 'any applicant for a permit
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
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
orimprovement is sold within one year of completion, the owner -builder will have the burden "
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 td 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 improvesthereon, and who contrasts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) _ .)
❑ I am exempt under Seca B. & P.C. for this reason
_ t
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
❑,Copy is filed with the city. O 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 ($100) valuation
or less.)
I certify that In the performance of thF work for which this permit is issued, I shall not
employ any-Ferson in any manner so as to become subject to the Workers' Compensation'
Laws of Caliornia.
Date Owner
NOTICE TO APPLICANT: ft, 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
Ihereby 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 appllcant Date
Mailing Address
City, State, Zip
No. 9972
LDING: TYPE CONST. . 'OCC: GRP.
Number
I Description :
Project Description
Model #3f3j;�
Sq. Ft. No.
Size 1659 Stories
No. Dw.
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Permit does not include block call
or
IEsti mated Valuation 97,077.30
PERMIT
AMOUNT
Plan Chk. Dep.
250.00
Plan Chk. Bat.
284.26
Const.
..
6343.50
Mech.
" r 49.'50
Electrical
•134.29
Plumbing
150.00
S.M.I.
3.880
Grading
20.00
Driveway Enc.
20.00
Infrastructure
2184.24
TOTAL
"73732-.'59
3482.'59-
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR SQ Fr. ®
GAR. SQ. FT. ®
CARP. SQ. 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
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
LAUNDRYTRAY
AIR HANDLING UNIT CFM
GAS' (ROUGH)
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
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.Ff.GAR ® 3/ic
HOUSE SEWER
GRADING
cu. yd.
$ plus x$
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 u `
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWEK
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$
=$
LUMBER GR.
FINAL INSP.
FRAMING a� 4 W
FINAL INSP.
ROOFING (
G
fctw "/
4,�
n
I
`
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LAT ING J /7707q d Lo
MESH
INSULATIONISOUND /24a LC
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL
a'1V LLIL n JUIL, � �.r�
CITY OF LA OUINTA
AM DEPARTMENT OF PLANNING 8t DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Owner Williams Development Cor
Contractor S ame
Permit Number 9271
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOB ADDRESS /11
:rmit does not include block wall or
)ol
TYPE OF INSPECTION DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING / / / O 7
DO NOT POUR CONCRETE UNTIL ALL AB VE HAS BEEN SIGNED
CONCRETE SLAB [ t C
JOISTS 8 GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS 8 GAS TEST 11 L
HEATING 8 VENT -A/C
FIREPLACE
BOND BEAM "LlV.U
O.K. TO WRAP
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
EXTERIOR LATH 09
(POOL PRE PLASTER
POOL FENCE 8 GATE
SEWER SNR iA !� ,
FINALS
PLUMBING
FINAL GAS TEST Z
HEATING - A/C
HOUSE NUMBERS If
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4!ee