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Building
7&105 CALLE ESTADO
- LA QUINTA CALIFORNIA 92253
Address �$ i
Owner { der
PQOL .
Mailing
BUILDING...,TYPE, CONST. RA OCC: GRP. "
Address
1 nn—w, s r .ti,-,o,. ,12 A.P. Number
City
�ilAs' a: 7% . ,',, Legal Description v
Contractor Project Description .: I'�'! h� �;f3! rfBTiiia r
. _ T�T9�T.'••TT.. L .
.''M AAb1'0w 9 AM
Address ss s, w • a vetsw ! Iii
City ,... ZIp.. Tec'
92260. 340-9000
State Llc City
& Classrf : Lid. # Sq. Ft.'.—No. No. DW,,_1851102 C- 3
Arch Engr Size Stories Units •
'DesignerNew 0 Add 0Demolition ❑
Address Tel.
City Zip' State
Lic. #
` iCldENSEDJCONTR}}¢ TCrR'S DECLARATION `
I hereby affirrrfjthat I m licensed under pf Ans of Chapter 9 (commencing with Section 4+„
70 fact of Drv�.is� n �3 0� (��N/baine'ss and Pcofe slon�Code, and my license is in full force and 3
effect: V X1 1 !/
SIGNATURELLL"' I y i .(
'OWNER-BUILDER DECLARATION Estimated"Valuation
hereby affirm that,l am exempt from the Contractor's License Law for the following ® u.
t reason`(Sec." 7031.S,Business and Professions Code: Any city or county which requires a � -
r t L
permit'to construct, alter, improve, demolish, or repair any structure, prior to its Issuance also - AMOU"NT.
requires the applicant /or such permit to file a signed statement that he is licensed pursuant to PERMIT.:' - ,
the provisions o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
` Division 3 of 4he Business and Professions Code, or thathe is exempt therefrom, and the basis
-,for the alleged exemption.-Any violation o/ Section 7031.5 by -any applicant for a permit Plan YChk' Dep.
subjects the applicant to a civil penalty o/ not more than live hundred dollars,($500). , ,,, . • .-r {
' ❑,l, as owner of the property, or my employees with wages is. their sole compensation, will Plan Chk. Bal. 00; -is 1Z
_ o ¢,•
do the work; and the structure is not intended or offered for sale. (Sec. 7044, .Buisness and �+ 1'•
Professions, Code: The Contractor's .License Law does not apply to an owner of 'property who Const.
buildsof Improves thereon and who does such work himself or through .his own employees, - - - 1°`' ,;F•
provided "that' such improvements, are not intended or offered /or sale. If, however, the building Medh�.
or improvement is sold within one year of completion, the owner-builder will have.fha burdenElectrical ►'
r •v
of proving that he did not build or improve for the purpose of sale.) -41S. 44
x;.
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-, Plumbing
struct the; project. (Sec. 7044, Business and Professions Code: The Confracfor's'License Caw 'S
does nota 1 to an owner o/ property who builds or im roves thereon, and who contracts for - - +•r. '• v
apply P P Y P S.M.I: 1• _
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
' 1 Grading t
❑ 1 am exempt under Sec:' B. & P.C. for this reason"
Drivewa- Enc.
y
Dateowner: Infrastructure
WORKERS'. COMPENSATION DECLARATION _
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:) -„ ;.; sc.n na zaie
Policy No:Com an .. _ a I "" r v '" T
❑ Copy is filed with the city. - O Certified copy is hereby furnished. '`tv 43 t
TOTAL . s
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 y'
employ any parson in any manner, so as to become subject to the'Workers' Compensation
Laws of California. ` w q
Date _'�_Owne
NOTICE TO. APPLICANT If, after' making this Certificate of Exemption you should-become ZONE: - -BY:
subject to the Workers' Compensation 'provisions of the Labor-Code, you must 'forthwith .
comply with such provisions or this permit shall be deemed revoked. ..�• .. , Minimum Setback Distances:
Front,Setback from Center Line
Rear Setback r}_ Rear Prop Line
CONSTRUCTION LENDING AGENCY Side Street S back from Center Line
I hereby affirm that there is a construction lending agency for -the. performance of the q
work,for which this permit is issued. (Sec.3097, Civil Code.). - _ - Side Setback :fl•Dm Pro perty,'L'ine `4
Lender's Name
Lender's Address V
This is building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
a
expiration if work thereunder is suspended for 180 days.
�'A certify that (:.have read this,applicmion'and state that the above Information is"correct• 'Issued by:. Date - � Permit', t '
Lagree to comply with all city and county ordinances and state lawssrelating to building S,
construction ;and hereby authorize representatives of this city 'to enter the -above-.,`
" mentioned property for Inspection purposes. s ' Validated by:'
Signature.of'applicant r Y.—Date' =
Mailing Addresst • Validation: '
City,.'Staie, Zip F
+T 7.. r _r r+ y ... �c .t k. .� r ..A 'sy��.••� .OM1 rr t4 t int i
t _
/`. Y ,x'--" .4 Z*; ` 4 i •Y", l •.•±:a S t.r .. r�ri 1,. fy r -.7 ; .M: r r _}
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WAiER PIPING
NOTE: Not to be used as property tax valuation
STORAGE TANK
FLOOR DRAIN
MECHANICAL FEES
DUCT WORK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REINF. STEEL
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP.
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIRE ZONE ROOFING
SO.FT.GAR ® 3/ec
HOUSE SEWER
FIREPLACE
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 &NDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) LI n To C.D 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
/
G � fj J (1 r�ji � �
�(� /�•S /'�� /�
/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL