07211 (RPL)Building 77-232 Calle Flora
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 47211
Owner Gene Brvwn
BUILDING: TYPE CONST.
A.P. Number
OCC: GRP. -
631-771-021
Mailing
Address 41-910 Boardwalk X3-10
City
Zip
Tel.
Paln, Desert
92260
Legal Description
Project Description
Pte.
Contractor
v Southpoint Comstruction
41-190 Boar lk 0-10
City
Palm Desert
Zip
92260
Tel"
345-5521
State Lic.
& Classif. 447M
City
1Lic.# 1134
Sq. Ft.
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
CityZip
State
"i
L•ic. #
LICENSED CONTRACJOWS DECLARATION
I hereby affirm that I am liarised'under provtsions:of Chapter 9 (commencing with Section
7000) of Division 3 of the Susi d Professions'Code, my license is in full force and
effect. f � OXf / 7 �
SIGNATURE !' ,-T1� t' r f'-'"'✓' a DATE
. OWNI RWBUILOER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business'and Professions Code: Any city or county which requires a
Permit to construct, atter, krprove, demoish, or repair any stnrctie, prior to its Issuance also
requires the applicant for such permit to tie a signed statement that he is licensed pursuant to
Me provisions of the Contractors Ucense taw, Chapter 9 (cormericirg with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and Ne basis
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penaity of not more Man five hundred dalars ($500).
❑ 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 Contractors License Law does not appy to an owner of property who
(wilds 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
Estimated Valuation
$201000
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
• '�
Const.
207.013
Mech.
Electrical
Muo
or improvement is sold within one year of conpielion, the owner -builder wil have the burden
of proving that he did not build or improve for the purpose of sale-)
O 1, as owner of the property, am exclusively contracting with licensed contractors to corn
Plumbing
2 •CT
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 Lrproves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractors License Law.)
❑ 1 am exempt under Sec a_ & P.C. for this reason
S.M.I.
r
•45
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workefs Compensation Insurance, ora 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
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or fess.)
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.
REMARKS
t1(}'rj i (iI , ,(, 4 r 11 S ; ti rS."::Z O T, 1-. t' -•
Date Owner
NOTICE TO APPLICANT: t, 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 shat be deemed revoked.
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, CW Code_)
Side Setback from Property Line
Lender's Name
FINAL DATE
N��CrTOR
yii
Lenders 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.
1 ceriity 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.
Issued by:
Validated by:
Date Permit
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
A.C. UNIT
COLL AREA
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
ROUGH PLUMB.
BONDING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT, ®
FORMS
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
DUCT WORK
DRAINAGE PIPING
CAR P. SQ. Ff.
GAS (ROUGH)
WALL SQ. FT.
METER LOOP
DRINKING FOUNTAIN.
SOFT ®
OTHER APPJEQUIP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GAS (FINAL)
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
GROUT
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
APPLIANCE DRYER
FINAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FINAL INSP./
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
REMARKS
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
FIREPLACE
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 K 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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP./
$
GRADING
cu. yd.
—Plus—X$—=$
LUMBER GR.
FRAMING
FINAL INSP. — ^�
ROOFING
,�
iw
/')
//
,�
REMARKS
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION / d��(
a
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL