002840P.O. BOX 1504
Building 49^430 Wast w tSt� LA QUINTACCALIFORNIA 92253
Address
Qwitzs
�a Estates, BUILDING: TYPE CONST. OCC: GRP.
' Mailing
Address p.o.B=Zis
A.P. Number -
CityZip
Tel.
.-_ � eta.
92253
5641-4644 •
Legal Description
Project Description
Contractor
JkceNli�i� cy-
Address
41-9 0 j9�8 E14'
' City .._
Zip
State Lia
City
& Classif.Lic:
2$ °
#'
Sq. Ft.
Size
No. No. Dw.
Stories Units
-Arch- Engr., .
Designer
New Qt Add ❑
Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
W W '� and J3
Au sem." . aa- ncftcm M
City .Z
ip
State
Lic. #... ... _ .
f LICENSE D. CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencingjwith Section
7000) -of Division 3 of the Business and Professions Code, and my li'cense.isiyr'�,fuII force and
effect..i(. .j , l c. Al,+F v! -_1
r�
x
., SIGNATURE- 41 "+...ate 0 DATE
rOWNER•BUILDER DECLARATION,
I hereby affirm that I am exempt from the Contractor's License Law for the following.-'.
. reason: .(Sec. 7031.5,Buslness antl 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 lhe,applicant for such permit to file a.,signed-statement that he is licensed pursuant to
the provisions o/ the Contractor's License Law,' Chapter 9 (commencing with Section ..7000) of.
Division 3 ofthe 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 civil penalty of not more than give hundred dollars (5500):' `'' ' �"•
's
O. 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
Estimated Valuation
�. p
- {� • ,-
-PERMIT
..•AMOUNT '
Plan-Chk., Dep.
- - -
--
Plan Chk. BBI.
Cif
2sJ`
Const...707-
eA 5r�2
Mech.
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 butld or jmprove for the purpose of sale.); -
Electrical
.
Plumbing
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
Strutt the project. -(Sec. -:70'44; 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:)
O -I am exempt. under. Sec. B. & P.C. for this reason
_
S•M.I "
• -
- '
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION.
1 hereby affirm that l have a certificate of consentto self -insure, or'a-certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company -
0 Copy is filed with the city.; ..O Certified copy is hereby furnished:
„r
TOTAL
3U.02
CERTIFICATE OF EXEMPTION FROM ''
• WORKERS' COMPENSATION INSURANCE
REMARKS
(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 proJisions- of the Labor code, you must` to
comply with such provisions or this permit shall be deemed revoked.-
ZONE: BY:
Minimum Setback Distances: -
Front. Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY ,
1 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.) ..
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
DATE
FINAL DATE
FINAL,
-Issued' by:
Validated by:
Y
—INSPECTOR
Date i x� Permit
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to '
if work thereunder is suspended for 180 days.�y�y
I certify that I have read this. application and state that the above information is correct.
I'agree to 'comply with all pity and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to nter the' above.
mentioned property for inspection purposes. .MA ,l
T
Signature of applicant % # .✓ I t a ,� 'en
Mailing Address ' ' .e, l
-Validation:
A%126
1 16 5.13.62 Ck.
_
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SQ, FT, ®
CAR P. SO. 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
WATER PIPING
NOTE: Not to be used as property tax valuation
A.C. UNIT
FLOOR DRAIN
MECHANICAL FEES
ROUGH PLUMB.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
HEATING (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SEWER OR SEPTIC TANK
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 GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
GAS (FINAL)
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
WATER HEATER v
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 APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER v
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
-
..
DEC
E
_
Y
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
IUM"J 01%XNA 1 UMrW I M I I IALJ,
GARDEN WALL FINAL
CH .PXIG;T'c? .. _. .
W• -r: dt- 'Nva HE -1&4r
j 2-x 8 x � a c.rn.0 • Cir-�cl�oN -t��
LAP 2411 INN.
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SECTION _
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CONCRETE'. BLOCK COLUMN .-DETAIL"
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MONTERO
ESTATES
ACcEss CONTROLS
LA
QUINTA,..
_CA..:._..._:_.....:..:
PALM DESERT,...._._...._._._ `_.CA
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_._.. -56$-.007.8