13889 (RR)P.O. BOX 1504 No. 13889
Building 78-105 CALLE ESTADO
Address 49"091 Washington St. LA QUINTA, CALIFORNIA 92253
Owner Triad Enterpri"s C/o Inn Tuttle
Mailing BUILDING: TYPE CONST. OCC: GRP.
Address P.O. BOX 9S
A.P. Number.
City Zip Tel.
La Quinta, CA 92253. 5$4-2$77 Legal Description
ContractorMroof
Custom-Roofing Company Project Description
1d1[e6RanChO LOS Coyotes
R160, CA zik2.02 Teli4,"3 %.1
State LiC. 1 Cit
& Classif. a-39 .625038 Lio # �.2 Sq. Ft. No. No. Dw. y
. '
Size 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 licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business an8!Professions Code, and my license is in full force and
effect. ! rs 1 ry
SIGNATURE DATE
OWNER-BUILDER DECLARATION Estimated Valuation$2-,111780.00
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: ,(Sec.: 703 1.5, Business 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 PERMIT AMOUNT 4
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of i
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 Plan Chk. Dep.
subjects'the applicant to a civil penalty of not more than five hundred dollars (S500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 30.00
y
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.JQ . QO
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
of proving that he did not build or improve for the purpose of sale.) ,
O 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 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 contractors) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
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.)
Polico. Company
C*Copy is filed with the city. ❑ Certified copy is hereby furnished. n
TOTAL '
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 the 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 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 lendingagency 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
This is a building permit when properly filled out, signed. and validated,_and is subject to FINAL DATE INSPECTOR.
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: -Date_P rm),t
I'agree to comply with all city and county ordinances and state laws relating to building A v
construction, and hereby authorize representatives of this city to enter the above-. 1
UG
mentioned properly for inspection purposes.Validated by:
Signature ofapplicant Date �` �✓94 //�' /
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
>`
2ND FL. SO. FT. @
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SO. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
DRINKING FOUNTAIN.
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
'
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ -Plus-X$-=$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
VENTILATION
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SO.FT.GAR ® 3/ac
HOUSE SEWER
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
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.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEGUIP.
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 �.�0�
C// LD
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F
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION 3�_OJ
[(
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL