15778 (RER)P.O. BOX 1504 No. 15778
dress 44 -060 Golden Rod LA QU1NTA, CALIFORNIA 9
Ad2253
j Address
i Owner
I
Mailing Mr. & Mrs.. Altman BUILDING: TYPE CONST. OCC. GRP.
i
Address Same
A.P. Number
City Zip Tel. y '
La... Quinta, CAI 92253 Legal Description
ContractorRemove? 42" Window and install
i Owner/BuilderProject Description
Address Preach fir. remove 4' wall to kitchen
'
City Zip Tel.'
State Lic. City
& Classif. Lic. # Sq. Ft. No. No. Dw.
_Arch., Engr.,
Size Stories Units
Designer New ❑ Add ❑ 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 Contractors License Law for the following $1,000.00
reason: (Sec. 7031.5,19usiness and Professions Code: Any city or county which requires a
permit to construct, after, 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 alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep.
I
sublPts the applicant to a civil penalty of not more than rive hundred dollars ($500).
Els owner of the roe y y g p Plan Chk. Bal. 16.25
p p rty, or m emplo ees with wa es as their sole com ensation, will
, the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 25.00
Professions Code: The Contractor's License Law does not apply to an owner o/ 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
or proving that he did not build or improve for the purpose of sale.)
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
struct the project. (Sec. 7044, Business and.Professfons 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.1. .50
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
j ❑ I am exempt under Sec. B. 8 P.C. for this reason
Grading
e j Driveway Enc.
Dale owner r �•�-� % Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. ,Company
❑ Copy is filed with the city. O Certified copy is hereby furnished.
TOTAL 41.75
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit is for one hundred dollars ($100) valuation
or less.) ,
I certify tha�t in the performance of the work for whiCliRhis permit is issued, I shalhnot
Lmplo rally 2rson in any manner §o� to co e�subject to the Workers' Compensation
Laws h rhia`
/�D.�ate��°Owner
T NOTICE TO APPLICANT: 1/, alter g this CeitHicate o/ Exemption you should become ZONE: BY:
subject it the Workers' at this permit all be deemed
of the Labor Code, you must fortnwirn • Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Li
Rear Setback from Rear P e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback fr enter Line
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from f;erty L
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES. FINAL DATE INSP OR
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. Issued by: Date ermit
I agree to comply with all city and county ordinances and state laws relating to building /A
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: *.
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL. S0. FT. p
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME SVC.
BAR SINK
POR. SO. FT.
DUCT WORK
ROCKSTORAGE
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APPJEOUIP.
DRAINAGE PIPING
CAR P. I SO. FT.
TEMP. POLE
WALL SO. FT.
GROUT
DRINKING FOUNTAIN
SO. FT. ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_ $
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
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
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
GAR. FIREWALL
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
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
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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.
Q
FRAMING 1
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 SIGNATURES/INITIALS
GARDEN WALL FINAL 771
----------------,
i
KITCHEN
26� 7S°
CAll
I � urs i xvn
REMOTE WALL
DINING ROOM
REMOVE 4c' WDW
INSTALL 35" X 30 INSUL, TEMP,
FRENCH DOOR.
EXIST` -3 4X4 HDR TO REMAIN
(VERIFY)
NEW POOL DElf"KING e----
MIS & MRS ALTMAN
44060 GOLDEN ROD
fLQ QUINTA CA
1060-1179
ni nna �i erg
SCALE, 1141; = V
D E N
CITY®F LAQUINTA
BUILDING & SAFETY DEPARTNI
CONDITIONALLY
ACCEPTED FOR CONSTRUCTION
SUBJECT TO INSTALLATION AS PER
AND ALL APPLICABLE CODES
ENTRY
D00RS'
T
HALL
WAY
KITCHEN
i NEW 4X8
BEAM
i
WALL
REMOVED
i
PASS TNRU
SECTION
`, ('ALD 1 12 _ V
DIN'G ROOM
�T
KITCHEN
i NEW 4X8
BEAM
i
WALL
REMOVED
i
PASS TNRU
SECTION
`, ('ALD 1 12 _ V
DIN'G ROOM