11427 (SOTB)4P.44
O. 4 t ' .�•� N o . 11427
Building7_'$� Tate' z �oheY� 7&105 CALLE ESTADO i
Address LA QUINTA, CALIFORNIA 92253
Owner
San: ise Desert. Partners
M.ilinn
BUILDING: TYPE CONST. OCC: GRP.
Address 42600 Cook St.
A.P. Number
_
City
Zip
Tel.
Palm . Desert
92260
558--2828
Legal Description
Project Description
Pool Restroom
Contractor
National Mortgage '"and Co.
A Sale
City
Zip
Tel.:
r
State Lic.
City
& Classif. 288130
Lic. # 328
Sq. Ft.
Size
No. No. Dw.
Stories Units
Arch., Engr.,
New ❑ Add ❑
Alter ❑ Repair ❑ Demolitiori•❑
Designer
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing withsSectjon
7000) of D/ivis'��o/0t�ri3 1 the Business and Pro essions Code, and my license is in full Jorce and
effect. G -�^iS t1 l I--
'
SIGNATl1RE d DAA
OWNER -BUILDER DECLARATION r
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 permil..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 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 '
or improvement is sold within one year of completion, the owner -builder will have the "burden
of proving.lhat he did not build or Improve for the purpose of sale.)
Estimated Valuation
"
18,000
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
-
.122.85
Const.
" 189.00
Mech.
n
15.00
Electrical
- gQ. �'?'j
Plumbing
39.00struct
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
the project. (Sec. 7044, Business and Professions. Code: The Contractor's License Law
does not apply to an ownerofproperty who builds or improves thereon, and who contracts for
such projects with 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,
1.80
Grading
Driveway Enc.
_
Date Owner
Infrastructure
405.00
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
b.Copy is filed with the city.0. Certified copy is hereby furnished.
TOTAL
813.35
CERTIFICATE EXEMPTION FROM
- WORKERS' COMPENSATION INSURANCE
REMARKS
A� 11
(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 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
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
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
FINAL DATE
Side Street Setback from ('center Line
Side Setback from Property Line
INSPECTOR
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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date .
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT.
GAR. SQ. FT. ®
CARP. SQ. FT.
WALL SQ. FT. @
SQ 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)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
TEMP. POLE
IKITCHEN 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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 V c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
REMARKS:
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
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./EQUIP.
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
F L INSP. V
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL