9468 (PAT)-IJ 1 �
P.O. BOX 1504 No.. 9 4 6 8
-4 '.
Building ttx040 78-105 CALLE ESTADO
Address
'922 Via Pompa LA QUINTA, CALIFORNIA 92253
�� .
Owner
craig.,Wats.on
BUILDING: TYPE CONST. OCC. GRP- A,
Mailing
Address A.P. Number.
CitylTel. Zip
La Quinta,- 92253 564-1-721 Legal Description
Contractor; Project Description
Mike Dempady Landscdpinq
Address
AND 3 ELECTRICAL OUTLETSr
P. 0. Box 3503
'City.1 1 . . izip Te.:
Palm Desert 92261 3
State Lic.'City
&Classif.-3.59001 C27 Lic. #
Arch., Engr.,,
Designer
Address Tel.
1902
Sq. Ft.
Size .
4- 2 0 No:
-Stories
Add 0. Alter 0
No. Dw
Units
Repair 0 -
City
zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
herebiaffirm that I am licensed under ion's of Chapter 9 (commencing with Section
of Division 3 of the Business and =Ong, Code,and my license is in full force and
effect ..
�G NATURE e
OWNER -BUILDER DECLARATION
• I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 703t.5,Business and Professions Code: Any city or county which requires a
t permit to construct, alter, ,improve, demolish,, or -repair any structure, prior to -its issuance also
!P,,requires the applicant for such permit to.file a signed statement that he Is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) -of
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
subjects the applicant to a civil penalty of not more than five hundred dollars.($500).
0 1, as owner of the property, or, my employees, with wages as their sole. compensation, will
Estimated Valuation .
-5208..00
AMOUNT"
Plan Chk..Dep.,
Plan Chk*.'Bal.
Const.
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
builds or improves there6n and who does such work himself or through his own employees, -
provided that improvements are not.intended or offered for sale. If, however, the building
Mech.
Electrical, J5.00
of improvement is sold within one. year of completion, the owner -builder will have the -burden
..ofproving that he did not build or improve for the purpose of sale.)
ff
Plumbing
0 1, as owner of theproperty, 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 contracts - for •
such projects with .a -,contractors) licensed pursuant -to the Contractor's License Law.).•
0 1 am exempt under Sec. B. & P.C. for this -reason
S.M.L. 60
Grading
Driveway Eric.
r
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.).
Policy No. Company
0 Copy is filed with the city. 0 Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE
REMARKS
(This section need not be completed if the permit is for one hundred dollars (5100) valuation
or less.)
I certify that in the performance of thp 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 �/ �wner V .�2f
10050,91i a4i- J2. li., jo-
ZONE: —BY:—
Minimum Setback Distances:
NOTICE TO. APPLICANT: if alter making this Certificate of Exemption you should become,
subject to the. Workers', Compensation' provisions of the Labor Code, you.1 must forthwith
comply with such provisions or this permit shall be.deemed revoked.
Fron t Setback from Center Line A,
—Rear Setback from Rear Prop:, Line
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction -lending ag6ncy for the performance of the
.work for.whic.h this permit is issued. (Sec. 3097, Civil Code.)
—Side Street'S6tback,from Center.Line
Side Setback from Property Line'
Lender's Name
FINAL DATE INSPECTOR
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject'to
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.
I agree to comply with all -city and county ordinances and state laws relating to building
construction, and hereby authorize representatives -of thiscity to enter the -above-.
mentioned property for inspection purposes.
Issued by: Date Permit --
Validated by:
Signature of applicant
DateMailing
Address
Validation.
'7
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CARP. 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
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
STORAGE TANK
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROCK STORAGE
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
METER LOOP
LAUNDRY TRAY
AIR HANDLING UNIT CFM
REINF. STEEL
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
EMP USE PERMIT SVC
[AMPERES
WATER CLOSET
COMPRESSOR HP
OLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
_ $
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE J PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR'
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
IAL
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.
FINAL INSP.
J
FRAMING t� 2 6 C
C l
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION vt�
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESfINITIALS
GARDEN WALL FINAL