10408 (SFD)1f �+
P.O. BOX 1504 N o . 10408
Building*� 78-105 CALLE ESTADO
Address 79-3'70 Desert Rice. Ct LA QUINTA, CALIFORNIA 92253
Owner
Address 45335 Desert 'Eja le Court
City Zip Tel.
La Quinti 192253 772-3336.
Contractor
Zip
State Lic. I City
& Classif.. 535587; Lic. #
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am -licensed under provisions of Chapter 9 (commencing with Section .
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
T '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, atter, improve, demolish, or repair any structure, prior toits issuance also
requires the applicant for such permit to rile a. signed statement that he is licensed pursuant to
the provisions or 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
i.for the alleged -exemption. Any violation of Section 7031.5 by 'any applicant for a permit
.subjects the applicant to a civil penalty or not more than rive hundred dollars.($500).
❑ 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 fdr 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 or property* who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
D I am exempt under Sec. B. & P.C. for this reason
Date Owner
WORK3PSI-COMPENSATION DECLARATION
I hereby affirm that have a certificate of consent to self -insure, or a certificate of
Worker's Compensationdnsurance, or a certified. copy thereof. (Sec. 3800, Labor Code.)..
Policy No.� 'Company-",
&Copy4s files •With the city.. -+"'O 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
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.
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 Dale
Mailing Address
City, State, Zip
a r
BUILDING: TYPE CONST. Y, OCC: GRP.:
A.P. Number
Legal Description "Tract 23935 Lot 16
Project Description SFD
Sq. Ft. No. No. Dw.
Size 2453 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolitiori ❑
REMARKS
c n�t{ta, � i`I th (15'ERt r A v 046 .28
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:
Estimated Valuation 137e007
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.A-50.32
Const.
882.00
Mech..
$0.00
Electrical
132.1.8 -
Plumbing
156.50
S.M.I.
10.13
Grading
Driveway Enc.
Infrastructure
3082.65
Arts in Public
92. 5.2
TOTAL 4866.28
REMARKS
c n�t{ta, � i`I th (15'ERt r A v 046 .28
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
`
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOMESVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. @
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
WATER SYSTEM
URINAL
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
FIRE ZONE ROOFING
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
LATHING
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE Z-11"P"LUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
/y
SLAB GRADE I v h
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
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
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 SIGNATURESIINRIALS
GARDEN WALL FINAL
SFD Lot 16
CITY OF LA WINTA
DEPARTMENT OF PLANNING & DEVELOPMENT
BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Owner GWR Development
Contractor Same
Permit Number 10 4 0 R
POST ON JOB IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOBADDRESS 79-370 Desert Rock Ct
TYPE OF INSPECTION DATE i INSP.
FOUNDATION & SETBACK b2z/ 14
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING 7;E7.%Vl!!
PRE-_GUNITE _
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
- CONCRETE SLAB
JOISTS & GIRDERS
ECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT -A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
p Z
GROUT ❑ 4' ❑ 8'
FRAMING
INSULATION
y
L 2
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
DRYWALL INTERIOR
, QZ
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
FI
ELECTRICAL
PLUMBING
FINAL GAS TEST
Nr 1TING - A/C
,SE NUMBERS
JOB COMPLETED
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING