003015 (GRES).. �. Ifs _ •r - ,,`_
P.O. BOX 1504 N o 1003-015 �
Building78-105 CALLE ESTADO
Address 528935-Avan:ida" Villa LA QUINTA, CALIFORNIA 92253
Owner '
clha rIea R. Dowd n
• BUILDING:' TYPE CONST. .. : OCC:.GRP:•:
Mailing - ..
Address . 52-935 Avenida Villa A.P.,Number . 77.3-333-021. £ 773-331-0124
City Zip -Tel. ' :.
Legal Description Lot 10 11.
-L-4- ou-i to
92253
Contractor _ ; Project Description . 550 • ' Ft f' ' ew rage
r Q isF�
Address. Convert -Mcl-sting !,"c'1e f�,
Den
City _. _, Zip .. Tel:'
State Lic. City �_� o Ga r
& Classif. Lic. # Sq Ftr No. No. Dw.
Arch:; Engr.; _.
Size `40 ° Stories -Units - 3
Designer New ❑ Add OX, Alter -El: Repair ❑'. -Demolition ❑ .
Address Tel.
CityZip State
.Lic. # .t
'LICENSED CONTRACTOR'S DECLARATION
hereby affirm that I am licensed under provisions of Chapter9 (commencing with Section '
7000) of Division 3 of the.Business and Professions Code, and my license is in full force and
effect..
• SIGNATURE DATE -
OWNER -BUILDER DECLARATION• -' Estimated. Valuation _
1 hereby affitm -that l am exempt from the Contractor's License Law for the.following^ 2�� �v
reason: (Sec. 7031.5,Business and Professions _Code: Any, city ,or county which- requires. a" , -
_ permit. to construct, alter, improve, and. Professions
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-- '
r the provisions of,the'Contractor's License Law, Chapter-9.(commencing with: Section .7000) of
Division 3 of the Business an'd Professions Code, or that -he is exempt therefrom, and the basis-
- .for the alleged •exemption. Any violation rof Section 703.1.5 by --any applicant for a permit: ' _ Plan Chk.�Dep.,.
•- 'subjects the'applicant to a civil penalty of not more than -five hundred'dollars,($500). ' "' ' " • . - - , -
Plan,Chk..BaL. i -
I, as owner of the 'property, my employees with wages astheir sole compensation, well +* �rY
v "do lhe:work, and the structure is not intended or offeredfor.sale. (Sec. 7044; Buisness and CiOnSt: IS 2. -Professions Code: The Contractor's License. Lawdoes-not-apply to; an`owner.of property -who - - a. V -'
builds, or improves thereon and who does such., work --himself orVhrough his. own employees,
provided, that' such improvements. are, not intended or offered -for_ sale.. -If,. however, the.. building .Mech. s a.♦ kJ .
or improvement is sold within one year of completion, 'the owner -bu0der •will have the. Burda . •• - .' 0 o.0 Ey. i
_ of proving that. he did not build or improve. for the purpose of sale.)'. ElectrlCal " dr.L iY .
b I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
r struct the project. (Sec. 704.4; -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.I: "' - ti _ ,.e _ l ``- • -
such projects with a contractors) licensed pursuant to the Contractor's License Law:J - .. -- �••
❑ I am exempt under Sec. • 8: 8 P.C. for this reason -- - •- - - '• - Grading -
Y Driveway Enc. 20m.10
i % v
Infrastructure -
v
WORKERS' COMPENSATION DECLARATION `
`I'hereby'affirm 'that 'I have`a certificate 'of c'onseht.to.self-insure,'or a:certificate of .
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
. Policy No.Company :
❑ Copy is filed with the. city.. ❑ Certified copy is hereby furnished
.TOTAL
CERTIFICATE OF EXEMPTION FROM. - " REMARKS
WORKERS' COM PENSATION.INSURANCE_.
(This section need not be completed if the permit is for one hundred' dollars (8100) valuation
... or less:). .. • .... .-
certify that in the performance of thg work for which this permit' is issued, I:shall not
employrany person in any mannerso as -to become subject:to'the Workers' Compensation
-1Laws of California.
..._. _.
:Date' -" Owner _ .
'NOTICE TO APPLICANT: If, after making - this Certificate of `Exemption you should become ' ZONE: - BY:- J.
"'subject to `the .Workers' Compensation provisions - of the." Labor Code; - • : -
P you .'mus forthwith Minimum.$etback Distances:
�- ,comply with such provisions or this permit shall be deemed revoked. � � - - 1 - -
Front.Se.tback from. Center Line
' Rear Setback from.Rear Prop.. Line
CONSTRUCTION LENDING AGENCY.Side Street Setback.frofTl Center.Lin2'
hereby affirm thaf there is a construction lending agency for the performance of the
work,forwhich this permit is issued. *(Sec. 3097,•Civil.Code.) •, - - $Ide,$etbaCk.frOm.PfOperty. Line'
Lender's. Name
Lender's., Address
- FINAL DATE INSPECTOR'
` 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. -- r I
.I certify that.I have, read this application and state that' the above mformation.is,correct - Issued by. Date A [! �8.IPermlt
agree to comply with all:city and county ordinances and state• laws'telating .to building"
Qu
construction, and hereby authorize representatives -of this city- to- enter - the above-.
mentioned property for inspection purposes. Validated by: + '
Signature of applicant Date
-.-Mailing Address Validation: - - ✓ t
City, State, Zip
A7 -b42 - 4 1:13, 11
T - HARD COPY ( ;
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
2ND FL. SQ. FT.
POR. SQ. FT. @
GAR. SQ. FT. @
CAR P. SQ. 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
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FORMS Sr �—
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SEWER OR SEPTIC TANK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
DUCT WORK
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. =T. @ c
BATH TUB
TEMP. POLE
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
FINAL INSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TO TAL 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 Sr �—
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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
flL� 1
4R1Q�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 6 (07
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL