9477 (SFD)• 4144
��
P.O. BOX 1504
Building 79--490 1adera Drive 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
X477
Mailing
BUILDING: TYPE CONST. OCC: GRP.
Address 29377 ncho Calif rnia 4200
A.P. Number
Lot 85 Quinterra ^r #23913
City • Zip
Tel"
171-4/676—R400
Temp -cu a 92391a
061
Legal Description
Project Description Plan 2A
Contractor.
•
1'aYislrB�rar t'a�ta 4•rtTr�'i A^ mt� ws�r
Lic. #
Address
same-
ameCity
City
Zip
Tel":
State Lic.
City
& Classif.
432.709
Lic" #
Sq. Ft" 2363 No. No. Dw.
Size Stories Units
' -Arch., Engr.,
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Designer Sroats Architectural Group
Address
Tel.
Permit does
not include block, walls or
City
Zip
State
061
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 Professions Code, and m license is in ffyll end
outs _
_SIGNATURE f DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
Estimated Valuation
126 178.80
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, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
PERMIT-
AMOUNT
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
Plan Chk. Dep.
' subjects the applicant to a civil penalty of not more than five hundred da0ars.(E500).
Plan Chk. Bal.
d i . 133
❑ 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
1 J4 • {i
Professions Code: The Contractor's License Law does not apply to an -owner of property .who, .•
_Const.
builds or impioves thereon and who does such work himself or through his own employees,
McCh.
' ' S 50
prodded Ifni such improvements are not Intended or offered for sale. If- however, the budding
. •
or improvement is sold within one year of completion, the• owner -budder wfd have the burden
Electrical.
158.77.
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
174.00
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not to an owner ,of. property -who builds or '
appy improves therean,�and who contracts for
S.M.I.
8 . 8 9 ' ,
• such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - 4
Grading
20.00
❑ I am exempt under Sec: B. R P.C. for this reason
Driveway Enc.
20.00
Date owner
283*9��.02
____II.nnfrastruucturrelf••� yy`■
t in
ic
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. .❑ Certified copy is hereby furnished.
TOTAL
4697.46
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 the work tot 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 became
subject to the Workers' Compensation provisions of the . Labor Code, you must forthwith
comply with such provisions or this permit shell 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
Lenders 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 1 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
Mailing Address
City, *State, zip
REMARKS
P0Siq7 JA 91J7 AR -14-9t 0
143 LRoN `1 1 I U I OL Z .441 (' .40
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
IST FL. SQ. FT. ® $
2ND FL SQ. FT.
POR. SQ. FT. ®
GAR. SO, FT. ®
CAR P. SQ. FT.
WALL SQ. 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
ilmly
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM. FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCK STORAGE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (ROUGH)
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
WATER HEATER
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
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 PLUMBIN4/*1( UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ilmly
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS`
�EWER OR SEPTIC TAN1d /— 1w
`` �� //
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 � ,q/tt)
(((
FRAMING �/
FINAL INSP.
ROOFING (
L�/
n '
r
cd
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND 16 A
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL