002644 (PAT)Building
Address 79-915 FieSta
Owner
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
City Zip Tel.
La Quinta 92253
Contractor
Address. .
No.. .002644
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description
- Milo .
' City
Zip
Tel.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
State Lic.
City
FINAL DATEINSPE
CTOR
I & Classif.
Lic. #
Sq. Ft. rat
No. No. Dw.
Validated by:
Size
Stories Units
Arch:, Engr., -
Designer
New ❑ Add ❑.X
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 and Professions Code, and my license is in full force and
�•
effect.
SIGNATURE DATE
,
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
JL4
'�
�Pt��
450
reason: (Sec.. 7031.5,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 rile a signed statement that he is licensed pursuant to
PERMIT
AMOUNT
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 Any Section 7031.5. any for
Plan Chk. Dep.
alleged exemption. violation of by applicant a permit
subjects the applicant to a civil penalty of not more than'five hundred dollars ($500).
Plan Chk. Bal.
36.77
O 1, 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 '
COf1St.
Y
56.50
Professions Code: The Contractor's License Lew 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.)
01, 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
S.M.1. --
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
❑ I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner V
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that'I have a"certificate of cdnsent to self -insure, 'or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
Q Copy is filed with the city. . O Certified copy is hereby furnished.
TOTAL
93.72
CERTIFICATE OF EXEMPTION FROM11�a'
REMARKS
i n- 'K� rrs +'•�-i A7�r1 ,t s
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
subject to the 'Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
I
. . CONSTRUCTION LENDING AGENCY .
I 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.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if 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 this city to enter the above
mentioned property for inspection purposes.
Signature of applicarf; Date
Mailing Address
City, State, Zip
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATEINSPE
CTOR
10-13-66
Issued by:
Date Permit
Validated by:
Validation:
MANU I;VYYI
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. S0. FT. ®
GROUT
WATER HEATER
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SO. FT. ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
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
%(/&OUND. REINF. ii
V
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
21/6RAMING94
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION ;/ k
V
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS,
GARDEN WALL FINAL