10405 (SFD)PO BOX 1504 No 10405
Building 45-'420 Desert Fox Drive 78 105 CALLE CALIFORNIAESTAD9
e.�.�.e�� LA QUINTA ORNIA 92253
Owner
771BUILDING: TYPE CONST. OCC: GRP.;
Mailing
Address 45305 Desert Eagle Court
City Zip Tel.
&a Quinta 1 92253 1772-3336
Contractor
Same as above
Address
Zip
State Lic. City
& Classif. 5355870 Lic. # 1615
Designer
Address Tel.
City Zip State
Lic. #
t LICENSED CONTRACTOR'S DECLARATION
t` I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
C 7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
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 rile 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 rive 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 contractor(s) licensed pursuant to the Contractor's License Law.) -
O I 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 Insuranc ,,or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. !Company''
X0 Copy -is -filed with the city" O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS'COMPENSATIONINSURANCE
(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 peon in any manner so as to become subject to the Workers' Compensation
Laws of
Cal ifornirsa.
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption youshould 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.
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
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.
1 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
.P. Number
Legal Description Trjat— 23CM T.ntS
Description CV21
009iAl Ori Ai.4St 11_40--04
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 Permi
Validated by:
Validation:
Sq. Ft. 1507
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolitiori ❑
Estimated Valuation
95.261..90
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
563.30
Const.
621.50
Mech.
62.00
Electrical
131.71
Plumbing
174.00
S.M.I.
8.60
Grading
20.00
Driveway Enc.
20.00
Infrastructure
2143.39
TOTAL
3745.50
REMARKS
009iAl Ori Ai.4St 11_40--04
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 Permi
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. 50. FT. ® $
UNITS
COLL. AREA
2ND FL. 5O. FT. ®
ROUGH PLUMB.
YARD SPKLR SYSTEM
POR. 5Q• FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. 5Q. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
DRAINAGE PIPING
CAR P. 50. FT. ®
GAS (ROUGH)
METER LOOP
WALL 50. FT.
DRINKING FOUNTAIN.
50 FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
SERVICE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
LUMBER GR.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FRAMING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
ROOFING
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.
SO. FT. ® c
BATH TUB
FIREPLACE
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® 3Ac
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 COND. SOLAR -
SETBACK
GROUND PLUMBIN l
b UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEIIf aa
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REIN
REINF. STEEL
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
� OTHER APPIEQUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATUAESIINITIALS
GARDEN WALL FINAL
SFD Lot .5
CITY OF LA QUINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Owner GWR Development
Contractor S ame
Permit Number 10409
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOSADDRESS -45-420 Desert Fox Drive
TYPE OF INSPECTION
DATE INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-GUNITE_
^� !!EE�
_OIw-
DO NOT POUR CONCRETE UNTIL ALL A
OVE HA EN SIGNED
CONCRETE SLAB
440
JOISTS 8 GIRDERS
=CTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS 8 GAS TEST
2
HEATING & VENT- A/C
FIREPLACE
ROOF
k__
BOND BEAM
O.K. TO WRAP
DAp
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR VL'
EXTER)OR LATH
Z
POOL PRE PLASTER
POOL FENCE d GATE
SEWER SEPTIC TANK
I I
FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST ��-
HF •TING - A/C
K SE NUMBERS
JOB COMPLETED j.
Aire-
TEMO-PbWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4!88
y' fit. � • .'. f J� r