09362 (SFD)Building
Owner
' u
P.O. BOX 1504
78-105 CALLE ESTADO
Y e �y x ,tLA QUINTA, CALIFORNIA 92253
Mailing
Address 45•-305 Desert Eagle Court -
City I Zip ITel.
Contractor
Address
Zip
State Ljc.S3�--6, I City
i£ Classif.Lic. #
Arch., Engr.,
Designer
Address Tel.
CityZip State
_ Lic. #
jfLICENSED CONTRACTOR'S.DECLARATION..
I hereby affirm lhat•,I am licenced under provisions of Chapter 9 (commencing with Section
7000) of Division 3,of thg Business and Professions Code, and my license is in full force and
• ' l OWNER -BUILDER DECLARATION
1 hereby affirm that'rI_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, 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).
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 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 that he did not build or improve for the purpose of sale.)
O I, as owner of the property, 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under. Sec. B. & P.C. for this reason
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
SLI Copy is filed with the city. O Certified copy is hereby furnished.
I ij`•
j CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
Of 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.
093&2.
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number,
Legal Description 'f.'rAnt 234351 Toppot Phar
Project Description Lot . $
Sq. Ft No. No. No. Dw.
Size 81 Stories. Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
136.26.3.9.,
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
633.70
Const.
769.00
Mech.
1150.00
Electrical
; 24 _ +fi'>j'1
Plumbing
S.M.I.
_
Grading
Side Street Setback from Center Line
Driveway Enc.
Infrastructure
3065.93
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
TOTAL 49n2.98
REMARKS
I certify that I have read this application and state that the above information is correct.
Date Owner
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
Setback Distances:
comply with such provisions or this permit shall be deemed revoked. '
Minimum
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
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.)
Side Setback from Property Line '
Lender's Name
Lender's Address
FINAL DATE
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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 Permit
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.
Validated by:
Signature of applicant Date -
Mailing Address
Validation:
City, State, Zip
777 7
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
ROCKSTORAGE
FOUND. REINF.
DRAINAGE PIPING
CAR P. SQ. FT.
METER LOOP
HEATING (FINAL)
WALL SQ. FT.
REINF. STEEL
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
BOND BEAM
WATER SOFTENER
VENT SYSTEM FAN EVARCOOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
/�
FRAMING 0r -/
ROOFING E66 I G Q
-1
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
LATHING ( 8 Q
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.
SQ. FT. RESID ® 1+/* c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEEMECH.FEE
PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING 3 � 9
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TAN / CQ
CC
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
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
rf
n A FINAL INSP. Y �$
FINAL INSP. X� y. �l U
^ � / /5REMARKS:
y1_ / (�/ (/ , ( (?
��VENTILATION
b 1ilr�d y i
i
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
/�
FRAMING 0r -/
ROOFING E66 I G Q
-1
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING ( 8 Q
MESH
INSULATION/SOUND C G
FINISH GRADING
FINAL INSPECTION �l�a
UU
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL