06476 (SFD)Building
Address 44-330Fo'stail Circle
Owner r .
Lia Qulata Associates
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA,.CALIFORNIA 92253
Mailing
Address 43--875 Wasbingt= '
City Zip Tel.
Palm Desert 92260 345,«,7541
Contractor
R. G. Williams Revs Corp. z
Address
Sawa
City Zip Tela
State Lic.493919 I City 1231
& Classif. Lic. # Y
Arch., Engr.,
Designer
Address Tel.
City IZip I State I
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.
J
SIGNATURE _ DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busiress and Professions Code: Any city or county which requires a
permit to construct, after, improve. demofsh, of repair any structure, prior to its issuance also
requires the applicant for such permit to lite 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 crvg penafly of not more than rive hundred dollars ($500).
O 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 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,
provided that such improvements are not Wended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not bufid or improve for the purpose of sale.)
❑ I, as owner of the property, 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 burros or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec- B. & P.C. for this reason
Date Owner
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.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed B the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of
California-
Date-Owner
aliforniaDateOwner
NOTICE TO APPLICANT: B, after malang this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this Perm@ shag be deemed revoked.
i
I r CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the .
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-.
mentioned property for inspection purpose&
Signature of applicant Date
Mailing Address
City,. State, Zip
No. 06476
BUILDING: TYPE CONST. OCC: GRP._
'
A.P. Number Tract -22992 Phase III
Legal Description
Project Description x l= 5$R Let 91
REMARKS Anrlil!7 .Sit 91.4Sti—t5+ »ft9_ — 0
ZONE: BY:
Minimum Setback Distances:
Front Setbackl-r m•Center Line
Rear Setback from Rear Prop. Line }
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
10/4/89
Issued by: Date Permit
Validated b -y:
Validation:
1
Sq,Ft. 2134
Size
> No.-
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$213,413
PERMIT '
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
570.37 -
Const.
Q$e..9_f0
Mech..
Electrical
Plumbing
S. M.I..
a9$�
Grading
Driveway Enc.
Infrastructure
2,551.79
TOTAL
$4,130-76
REMARKS Anrlil!7 .Sit 91.4Sti—t5+ »ft9_ — 0
ZONE: BY:
Minimum Setback Distances:
Front Setbackl-r m•Center Line
Rear Setback from Rear Prop. Line }
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
10/4/89
Issued by: Date Permit
Validated b -y:
Validation:
1
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
�% �O� _
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT, ®
DUCT WORK
ROCK STORAGE
GAR. SQ. FT, ®
POWER OUTLET
ROOF DRAINS
R LOOP
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SO. FT.
GAS (FINAL)
WALL SQ. FT.
DRINKING FOUNTAIN.
GROUT
URINAL
SQ FT ®
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
HOUSE SEWER
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 4-11e
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
�% �O� _
UGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
W„
�7 !Jr
y:b'p
S (ROUGH) Q
R LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM WATER SYSTEM
GRADING
LUMBER GR. FINAL INSP. p cu. yd.
FRAMING z�r ��all FINAL INSP. D Th -plus -x$_=$
ROOFING 2"C �n IM I REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING .#C,I/
MESH
INSULATIOWSOUND _LJ
FINISH GRADING
FINAL INSPECTION-
CERT. OCC.
FENCE FINAL
GARDEN WALL FINAL