05187 (SFD)I
4
P.O. BOX 1504 N o • 05187
Building 78-105 CALLE ESTADO
Address 44-210 alkea Cirel.p. LA OUINTA, CALIFORNIA 92253
7^p (t%14.n* '� �' { �° M.
BUILDING: TYPE CONST.
OCC: GRP.
Mailing.
Address 43-875 Washington St'.
A.P. Number
Cactus Flower
City
Zip
Tel.
Palm Desert
1 92260
345-7541.
Legal Description
Project Description
Phitsp_ T. Plan IRE, Lot TA
Contractor
E. G. Williams Dev. Caro.
Address
1r( �
City
Zip
Tel."
State Lic.
& Classif. 493919
City
Lic. # 1231 _ _
Sq. Ft. 1633
No. No. Dw.
Size'
Stories Units
Arch., Engr., -
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ 'Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70pp) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE a DATE
OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.S.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
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 (5500).
O 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 andCOnSt.394.00
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 safe.)
Estimated Valuation
!+ $
$ , C,
PERMIT
AMOUNT
Plan Chk. Dep.
'
Plan Chk. Bal.
S 339.25
Mech.
3�j Q(l
•
Electrical
-` - 72.53
Plumbing
82.00
O 1, as owner of the properly, 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.)
O 1 am exempt under Sec- B- & P.C. for this reason
S.M.I.
6.06
Grading
Driveway Enc.
Date net
Infrastructure
1,953.36
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
.. O'Copy is filed with the city- O Certified copy is hereby furnished.
TOTAL
S29883.40
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
ti V
I41 .+R I G.4a Rj i'(i�
(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.
-1r,
tr(1 ( t } fit. i r_'t it3 5 . cL!
M"
Date Owner
NOTICE TO APPLICANT: N, 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 shah be deemed revoked-
ZONE: BY:
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
FINAL DATE
INSPECTOR
12/29/88
Lenders Address
This is a building permit when property 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-
Issued by:
Validated by:
Date - Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SETBACKD
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
A.C. UNIT
COLL. AREA
SLAB GRADE
MOBILEHOME SVC.
BAR SINK
POR. SQ, F7. ®
HEATING (ROUGH)
STORAGE TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
ROUGH WIRING
DUCT WORK
DRAINAGE PIPING
CAR P. SQ. FT.
JZ (iL� /"/
Y
(ROUGH)
WALL SQ. FT.
HEATING (FINAL)
DRINKING FOUNTAIN.
REINF. STEEL
URINAL
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
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 GOND. SOLAR
BOND BEAM WATER SYSTEM
GRADING
LUMBER GR. FINAL INSP. cu. yd.
FRAMING INAL INSP. $ plus x$ =$
ROOFING REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR l `-OLP/�
GAR. FIREWALL
LATHING 0(4 -1 b'!/
MESH l
INSULATIONISOUND Cy
FINISH GRADING
FINAL INSPECTION 1
1
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL
SETBACKD
PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
19:t400;101ROUGH
PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
JZ (iL� /"/
Y
(ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
�-y
GAS (FINAL) �� C/.
C/
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM WATER SYSTEM
GRADING
LUMBER GR. FINAL INSP. cu. yd.
FRAMING INAL INSP. $ plus x$ =$
ROOFING REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR l `-OLP/�
GAR. FIREWALL
LATHING 0(4 -1 b'!/
MESH l
INSULATIONISOUND Cy
FINISH GRADING
FINAL INSPECTION 1
1
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL