09368 (SFD)P.O. BOX 1504 �° ly}� N0. 09368
Building7&105 CALLE ESTADO f
Addres7$--335 Desert Rook Court LA QUINTA, CALIFORNIA 92253 � !
Owner
CWR n LO IANT BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address Desert Eaczle Court A.P. Number
Tel.
' ti *�t a D2253 772--333E
CityRipel.
Description''ra�c�d� 7101% �t'a�tha� T2i�r o �
,Contractor Project Description Tats 26
Address
- � AfiFi•
City Zip Tela
State Lic. City
& Classif. �sri4.''7 Lic. # �$5 Sq. Ft. No. ` No. Dw.
Size 2.73 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 tic nsed und_er.provisions of Chapter 9 (commencing with Section
7000) of Division�3 of the Bu bess'a d Professions Code, and my license is in full. force and
effect.`"'
SIGNATURE jifMAX Y.°4i7yW"i W DATE
)/
OWNER -BUILDER DECLARATION
I herebyaffirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
reason: (Sec: 7031.5,Business and Professions .Code: Any city or county which requires a '12 9;5k11 0(v
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 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 .
Plan Chk. De
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Dep
-
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will 1 4
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 720 Q(f
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, Mech. ��
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 Electrical 71
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 138.50
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 S. M. 1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure 2758.21
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 �
py is filed with the city. ❑ Certified copy is hereby furnished. t
TOTAL Q
/to
CERTIFICATE OF EXEMPTION FROM REMARKS
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, aftermaking this Certificate of Exemption you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: '
comply with such provisions or this permit shall be deemed revoked.
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
Lender's Address FINAL DATE INSPECTOR
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.
1. 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:
i City, State, Zip
CONSTRUCTION ESTIMATE
NO: ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
V\ t
ROUGH PLUMB. BONDING
HEATING (ROUGH)
YARD SPKLR SYSTEM
2ND FL. SO. FT.
SEWER OR SEPTIC TANK/ OUGH WIRING
c�
DUCT WORK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GROUT
DRAINAGE PIPING
CAR P. I SQ. FT.
BOND BEAM
WALL SQ. FT.
GRADING
cu. yd.
$ -Plus-X$-=$
DRINKING FOUNTAIN
SQ. FT. ®
FINAL INSP. / /IZA I -v
URINAL
ESTIMATED CONSTRUCTION VALUATION $
ROOFING n a c
WATER PIPING
NOTE: Not to be used as property tax valuation
REMARKS:
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
SPARK ARRESTOR
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.
SQ. FT. ® c
BATH TUB
INSULATION/SOUND l L ( L h
�✓
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
I CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE / PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING Qw/ UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
V\ t
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK/ OUGH WIRING
c�
DUCT WORK
ROCK STORAGE
FOUND. REIN
GAS (ROUGH lll / 2 METER LOOP
l J
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$-=$
LUMBER GR.
FINAL INSP. / /IZA I -v
FRAMING 1, 1, H
FINAL INSP. / / C
ROOFING n a c
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LAQW
MESH
INSULATION/SOUND l L ( L h
�✓
FINISH GRADING
FINAL INSPECTION ' 014W
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL