05914 (SFD)Ti* 4 "
P.O. BOX 1504 N o . 1)3'314
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING: TYPE CONST. OCC: GRP.
A.P.'NUmber
Legal Description Photge TT lot .53
Plan 4C Cactus Plovmr
Project Description
Building
Address 44-3 W1.116w Ci rf~1n
Owner 1d Quinta Associates
Mailing
Address 43-875 VlaShi an ,,St.
City Zip 92260
E.G. Williams ice. Corp.
same
ty lZip Tel.:
State Lic. City
& Classif. 493919 Lic. # 1231
Arch., Engr.,
Designer
Address I Tel.
City(Zip I
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1. 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
OWNEWBUILDER DECLARATION
'1 hereby affirm that I am exempt from the Contractors License Law for the following
. reason: (Sec. 7031.5,Bus ness and Pmtessians Code: Any city or county which requires a
permit to construct, ager; irprove, demolish, or repair any structure, prior to its issuance also
requires rhe, for such pemtd to Rea signed statement that he is licensed pursuant to
the pro vi'lons,of the Combactors.License Law, Chapter 9 (commencing with Section 7000) of
,D)vlsion 3 oY(he Buskess and Professions Code, or that. he is exempt therefrom, and the basis
• loi, the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicarht to a ciwl penally of Trot 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, Suisness and
Professions Code: The C inbac[ors 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 irprovemets are not intended or offered for sale. If, however, the building
or improvement is sold wdhih one year of cerpietion, the owner -builder will have the burden
or proving that he did not build or hpove for the purpose of sale.)
❑ 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 contacts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. ti P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 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
El Copy is filed with the city- ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This secgon need not be completed 9 the permit is for one hundred dollars (S 100) valuation
or less.)
I certify that in the performance of lhp 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: 9, after makixj this Cetiricate of Exemption you should become
subject to the workers' Conpesation provisions of the Labor Code, you must forthwith
comply with such provisions or gds 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
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certity 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
Sq. Ft. 1$81 No. No. Dw.
Size Stories Units
New IX Add ❑ Alter ❑ Repair ❑ 'Demolition ❑
Estimated Valuation
PERMIT' a
AMOUNT
Plan Chk:-Dep.
Plan Chk. Bal.
9 ' 0
Const.
590..00
Mech.
53.50
Electrical
`113.7
Plumbing
123.00
S.M.I.
6.23
Grading
Driveway Enc.
Validation:
Infrastructure
2221.98
TOTAL
yd -'iacJ '?trt9.•�
REMARKS
_
:�-%).,Soyt;a Va�'�, �; ti'{;}•T NIt:=.".::r.lr.. t?ti vri: a'J c: +�%
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 -6-15-89 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
SLAB GRADE
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) 1
ER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR SQ. FT. ®
P. POLE
GROUT
DRAINAGE PIPING
CAR P. SQ. Fr. ®
FINAL INSP.
WALL SQ. FT.
WATER SYSTEM
DRINKING FOUNTAIN
SQ FT ®
=$
URINAL
ESTIMATED CONSTRUCTION VALUATION $
ROOFING Z
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING O I!/
MESH
INSULATIONISOUND j7
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
ccurc c�uw�
WATER PIPING
NOTE Not to be used as property tax valuation
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
LAUNDRYTRAY
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 I GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U. '
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ic
HOUSE SEWER
GAS PIPING
PERMIT FEE I
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
j MICRO FEE
MECH.FEE PL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE+ PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
6! -1 -01fT!
SETBACK
GROUND PLUMBING
UNDERGROUND
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.- j �D
GAS (ROUGH) 1
ER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL 0,
GAS (FINAL) .ylit /1.�
`7
P. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR. FINAL INSP. Z�
FRAMING �/ 2 �%� FINAL INSP.
ROOFING Z
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING O I!/
MESH
INSULATIONISOUND j7
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
ccurc c�uw�
REMARKS:
SIGNATURESIINITIALS
GARDEN WALL FINAL