09363 (SFD)Building
Owner
Tit,
P.O. BOX 1504 `: 1� N o .
78-105 CALLE ESTADO c `�-
>Ck C43uxt LA QUINTA, CALIFORNIA 92253
Mailing
Address 45-345 desert Eagle Court
City Zip Tel.
%a Quanta 92253 773-3336
Contractor
GWR DEVELOPMEW
Address
RAMP
City lZip Tela
State Lic. I City
& Classif. 535583 B Lic. #
Arch., Engr.,
Designer
Address Tel.
City ZipState
Lic. #
//f LICENSED CONTRACTOR'S DECLARATION
I hereby affirm1thatfl am,l)tensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3.6f the8 sinesslfiiPProfessions Code, and my license is in full force and
effect.. 1
' OWNEWBUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. L7031.5,Buslness and Professions Code: Any city or county which requires a
I- 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
ifor 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).
01, 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
OI proving that he did not build or improve for the purpose of sale.)
0 1, 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 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
Ihereby 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
\V)'Copy, is filed with the city- ❑ Certified copy is hereby furnished.
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 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 ' Owner
NOTICE TO APPLICANT: If, 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 shall be deemed revoked. '
CONSTRUCTION LENDING AGENCY
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.)
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.
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
I Mailing Address
I City, State„ Zip
4,7363
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number
Legal Description Tract 23935 Tonaz 1?ha tealI
Project Description Lat 24
REMARKS
ZONE:
BY:
Minimum Setback Distances:
Sq. Ft. No.
Size 25.81 Stories
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑.
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Estimated Valuation
1364263.80
Validation:
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
t 633.73
Const.
769.00
Mech.
60.00
Electrical
129.60
Plumbing
144.50
S.M.I.
9,S9
Grading
Driveway Enc.
Infrastructure
3065.33
TOTAL 4902.99
_
REMARKS
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
1ST FL. SO. FT. ® $
UNITS
2ND FL. SO. FT.
HEATING (ROUGH)
YARD SPKLR SYSTEM
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
ROCKSTORAGE
FOUND. REINF.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
REINF. STEEL
GAS (FINAL) TEMP. POLE
jDRAINAGE PIPING
CAR P. I SO. FT.
GROUT
WATER HEATER SERVICE
WALL SD. FT.
DRINKING FOUNTAIN.
SO FT ®
GRADING
cu. yd.
$ -Plus-x$-=$
URINAL
ESTIMATED CONSTRUCTION VALUATION $
f FINAL INSP. [`(q,' (�
WAl ER PIPING
NOTE: Not to be used as property tax valuation
ROOFING 5 2� O� C(� )
111
FLOOR DRAIN
MECHANICAL FEES
REM ARKS:
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L 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,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FINISH GRADING
SO.FT.GAR ® 3/ic
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 PLUMBING Ct Lt% UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
�! SEWER OR SEPTIC TANK OUGH WIRING
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) () 1 2 rS I 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$-=$
f FINAL INSP. [`(q,' (�
FRAMING —[ (C
`
FINAL INSP .`O �/
-/
ROOFING 5 2� O� C(� )
111
to
JJ
/�� 17CCS I
J` TTZZ11 CCCCC GG ((
REM ARKS:
VENTILATION 1
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. F REWALL
Q
THING a Cij
MESH
INSULATIONISOUND-) '3�lq
FINISH GRADING
FINAL INSPECTION A 2 ` 9�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL