002961 (CP)Building Tr. #19903, ra Qanta Palms
Address 79-259 FrW %� Drive
Owner
PW AMerb=n
Mailing
Address 387 W. Cm-wedumm AMM.
City lZip ITel.
Contractor
�. Address .
4 �wQ�rw
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 002991
BUILDING: TYPE CONST. 'OCC: GRP
P..Number
Legal Description
Project Description eta'
City
ZiP,
Tela
+ttra cif t
92234
323-7!3
State Lic.
City
& Classif. 6s3 lrJlw
Lic. # 3s5
Sq. Ft. No.
Size Stories
No. Dw.
Units
••Arch., Engr.,
Designer
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Address
Tel.
City �-�,
i . I'll ..
Zip j;
�%
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 Profession's,,Code, and my license is in -full force and
^effect...
SIGNATURE- DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Buslness 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 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 ($500). ' : '-
O I, as owner of the properly, or my employees with wages as their sole compensation, will
Estimated Valuationn
��V
V
-
PERMIT
- -
?•� AMOUNT
Plan Chk. Dep. -
Plan Chk• Bal.
'
Const.
••do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
i Professions Code: The Contractor's License Law does not apply to an owner of property who
Mech.
,
builds or improves thereon and who does such work himself or through his own employees,
provided that such improvements are not Intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Electrical
A 75.On
Plumbing
O I, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to -the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
S.M.1.'-
Grading
Driveway Enc.
Date Owner
Infrastructure
j WORKERS' COMPENSATION DECLARATION
I I hereby affirm that I have a certificate'of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
17 Copy is filed with the city. -❑ Certified copy is hereby furnished.
- - f . / rI
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is -%or one hundred dollars ,($ 100) valuation
or less.) - ti-
"I certify that in the,performance of thg ork for which=this pe�s issued, -1 s?hall not
employ'any person in any manner so as to;beco `e•subject to the Workers t£ompensation
Laws of California.
* %' Date/ Owner
'4NOTICE'TO'APPLICANT: If, affer'making this' Certificate of Exemption you should become
subject to the Workers' Compensation i provisions of 'the Labor Code,' you must forthwith
comply with such provisions or this permit 11 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
TOTAL
REMARKS
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
Lenders 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.
I certify that I have read this application and state that the above information is correct. Issued -by: Date 2/27/27 Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-
mentioned property for inspection purposes. -Validated by:
Signature'of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. I SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
SQ. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.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
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL