14407 (RC)t $» P.O. BOX 1504 No. 1 4 4 0
Building �Q_y % ,�78-495 CALLE TAMPICO
Address ��k��s
LA OUINTA, CALIFORNIA 92253
Owner
Dr. John waasenmiiaer,VN
S2,
BUILDING: TYPE -CONST.' ' - OCC: GRP.-
Mailing
Address P.O. '-8ok _2084
-11
A.P. Number
City Zip
Tel.
Palm Dkiber�,. A 9220-
3�iQ-�frJ$
Legal Description S� {f??. �30� 2 •.
ContractorTenant-
-:Duprove...me t
t i22CU �.. B.
Project: Description .
Address.
:. .
72500 Beavertail t.
.CVaL"t Desert,
zip 9226t}
TJ'
46-2166
State Lia
City
.�
& Classif. , B 354141
Lic. #
Sq. Ft. No. No. Dw.
Size- Stories -Units
Arch.,-Engr., istl ��?:i3 toil $ t;a.�2�w
'
'Demolition❑
Designers
New ❑ Add 0 . Alter p' Repair O
Adj.28s19 Dap` ine Ave .
Tel.
Cit
Rawthron, CA9i312so
Zip ..
State
Lia'#
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm t1WYl am -I used under,provlsions of Chapte 9`(comm ncring�with Se tion
000) of Div�is`ji,!'oJ{�,1r3 of the'Business andwf?iofessio s Code %a �fic�rfse.is.!'n full for ap�g
» e
• ,r effect: R > i v 7,ZA /
b
_$1GNATURE iDATE
i
OWNER -BUILDER DECLARATION
Estimated Valuation ' `p =010 1 00
I hereby affirm that I am exempt -from the Contractors License Law for. the following
reason: (Sec. 7031.5,Business and Professions Code: Any,cay.•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 thathe is licensed .pursuant to•
PERMIT' ' AMOUNT .. -
the provlsions of the Contractor's License'Law, Chapter 9.(commencing with Section 7000) of:.,•
Division 3 of the Business arid Piofessions 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 .Parma •
Plan. Chk. Dep.
subjects the applicant to'a civil pansy of not more than five hundred dollars ($500). -
- j a • "'
Plan Chk. Bal.
❑ 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
Const. ZU4 • t)U
- 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- 3. e.- To
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-
Plumbing.
-struct the project. (Sec. 7044, Business and .Professions Coder The Contractor's License -Law
does not apply to an owner of property who builds or improves thereon, and who contracts for.
r�
" S.M.I.- . v-
such projects with a contractors) pcensed pursuant to the Contractor's•License.Law.)
Grading
❑ 1 am -exempt under Seca B. & P.C. for this reason
Driveway Enc. `
Date owner ? -"`
Infrastructure
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.)-
a
Poli,�y.�o/ �mpany
/
f7 Gopy is filed with the city, O Certified copy is hereby furnished.
TOTAL �U
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_ .lf, after making , this Ceitlficate• of Exemption you should become'
-subject 'to
ZONE:- - •' BY: - -
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 Cent 1
•
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
Rear Setback from.Rep, Li
- Side Street Setback f' n Center Lin -
SHALL; SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP. TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback fromrPt I erty L
DAMAGES AS PROVIDED FOR IN SECTION 3706'OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
O
Tl is a building permit when properly filled out,.signed and validated, and.is subject to . '
FINAL DATE INSP \T.OR
expiration if work thereunder is suspended for 180 days. � - '' � •: - .
- e.
,.
99
I- certify that I have, read this application and state that the above information is correct.. •.
ISSUed'by: Date �: ermit ✓
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.' 1
Validated by:
Signature of applicant Date
f 1.
Mailing Address
Validation:
City, State, Zip
`�. h
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW; FEES'
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT, ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. 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
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE - DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c-
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
LUMBER GR.NAL
SO.FT.GAR ® VAc
HOUSE SEWER
FRAMING
INAL INSP2$
LLL
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
plus x$
_ $
LUMBER GR.NAL
INS
FRAMING
INAL INSP2$
LLL
ROOFING
G C
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR `
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING -
INAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
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Ttaof .1d. Ofail thita
it tltl all 'SafVt ikit, tltlt
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 50-855',.Washington Ste. G - • x
Use Classification: Dent i s t* O f f i ce Bldg. Permit No. - 14407
Group B2 Type Construction- VN Fire Zone Use Zone CPS '
Owner of Buildinq
Dr. John Wassenm.11er Address P.O. Box. 2084
City Palm Desert, CA 92261 Richard Kirkland
By:
Date: March 7, 1995
Building Offic al N
• POST IN A CONSPICUOUS PLAC[
Its
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f
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i I,I
t
0
xx� asp Q. '
4
0
Ttaof .1d. Ofail thita
it tltl all 'SafVt ikit, tltlt
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 50-855',.Washington Ste. G - • x
Use Classification: Dent i s t* O f f i ce Bldg. Permit No. - 14407
Group B2 Type Construction- VN Fire Zone Use Zone CPS '
Owner of Buildinq
Dr. John Wassenm.11er Address P.O. Box. 2084
City Palm Desert, CA 92261 Richard Kirkland
By:
Date: March 7, 1995
Building Offic al N
• POST IN A CONSPICUOUS PLAC[
Its