002488 (SIGN)44
P.O. BOX 1504 No. 00248$
Building 1,7 � Of 78 105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address 74-399 Illi, W 2 A.P. Number 617-0821
City Zip Tel.
�,� 9226 Legal Description
Contractor Project Description
_.. Address
8-%-591 BW LU ,
City. Zip Tel.' .
CbWhOUA 52236 -393-6313
State Lic. City
& Classif.. 233P49 Lic. # amlied Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
.Designer New ❑% Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. rwo (2) miry on-site "Rw sale" signs.
City Zip State
Lic. #
LICENSED CONTRACJOR'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 Professions Code, and my license is'm full force and
effect. 73 r,°
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, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant 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 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 -
Almated valuation � •
PERMIT
Plan'Chk. Dep.
Plan Chk. Bal.
Const.
t AMOUNT . '
6Va
builds or improves thereon and who does such work himself -.or through his own employees,
Mech.
,
• 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 .
Electrical
. 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 to con-
Plumbing
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
S.M.I.
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
-
Grading
. O I am exempt under Sec. B. 8 P.C. for this reason
Driveway Eno.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
T 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
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
�8a
CERTIFICATE OF EXEMPTION FROM
REMARKS
-
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 thg 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 "Oviner
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
work for which this permit is issued. (Sec. 3097, Civil Code.)
Side Setback from Property. Line
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit whenproperly 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.
'
Issued by: -
Date ermit
I agree'to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the, above-
mentioned property for inspection purposes. -
Validated by:
r
Signature of applicanI. �' ✓ Date
Mailing Address t•
Validation:
City, State, Zip
Ab031
7 23 20,00 CY
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
2ND FL. t SQ. FT. @
POR. SQ. FT. @
GAR. SQ, FT, @
CAR. P. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
QSLAB
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WA SHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
LAUNDRYTRAY
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
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/4c
HOUSE SEWER
REMARKS:
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE d
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
GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
QSLAB
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
FINAL INSP.
ROOFING
-
DEC 9 • 7
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