09385 (SFD)Building
Address 72-
' 4 u
P.O. BOX 1504
78-105 CALLE ESTADO
Mar LA QUINTA, CALIFORNIA 92253
Mailing
Address 1361 Dove Street
City I Zip Tel.
wriort Beach 3266€3 14/851-
Contractor
Address
Zip
State Lic.
& Classif.
Arch., Engr.,
Designer
Lic. #
No. 09385
JBUILDING: TYPE CONST: OCC: GRP.
Address Tel.
360 -0250 -
City Zip State
Lic. # C7424
LICENSED CONTRACTOR'S DECLARATION
I hereby -affirm that I am licensedi nder,provlsions of Chapter 9 (commencing with Section -
7000) Of,-Dwiivvlsii6n 3 of,the Bus!nness=end,Piofressionss Code, and my license in.full forceaynd
effect*.�
SGNATUR :. """' "" °%,e is `+�' 'n+"' ,F PLATE
� OWNER -BUILDER DECLARATION
I hereby affirm hat l am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Buslness 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 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 (5500).
❑ !,'as
owner of the properly, 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,Ucense 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.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- .
struct the project. (Seca 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.)
❑ 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
O Copy is filed with the city. .O Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the penult 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 Certlficate 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.) r
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 1 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
Mailing Address
City, State, Zip
A.P. Number
Legal Description Vlarwnassa inin T ak4t 7,A 0iiintA
Project Description Lnt 190 Plan 2
Sq. Ft. No. No. Dw.
Size 2924 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
,timated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
V
Const.
Mech.
— — n
Electrical
Plumbing
i 9
S.M.I.
`.
C*
Grading
Driveway Enc.
Infrastructure
fay nn
• •IbM w !b •..
v�.•�I •
TOTAL
1��.' �.. Y. P YIF:da
7267.39
C` {.i HF' � �11: r'::d!li`K R M i•. r, ( L
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
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
METER LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. SO. FT. ®
GAS (FINAL)
—4y --O
WALL S0. FT.
DRINKING FOUNTAIN.
SO FT @
URINAL
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GRADING
ecu. yd.
$ plus x$
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROOFING `
[
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
MESH
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 GOND. SOLAR
SETBACK G�
CCCC
l L/>
GROUND PLUMBING
(CVNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
Cy
up SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)Q 2J I
{iD
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
—4y --O
WTEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
'
GRADING
ecu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP O , %
c
FRAMING -1
FINAL INSP. W -134
ROOFING `
[
C
� / ` a�6 "-
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND S
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
00
soV 'al"Ivc
ra
4b.
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z EL l. - 9 v le ti
og ize a�oo
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awl hl b' a�
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of
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Tit�1 of Ila ouinta
lluitbint� altb $afpt�J 31t*11t+'!5t*VR
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS 78-815 Dulce Del Mar
Use Classification Single Family Dwelling Bldg. Permit No.
Group, R3 Type Construction VN Fire Zone Use Zone SR
Owner of Building Lake La Quinta Address Same
City La Quint a
By. T,nnni P Day
Dots; 8-9-9A
Building Official
POST IN A CONSPICUOUS PLACE