06832 (SFD)Buildin
Address 44'150 Goldenrod Circle
Owner
ba 4uinta Associates
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
maiiin
Address 43-875 Uaashington St.
City Zip Tel.
Palm Desert 92M 345.7541
Contractor
E.G. Williams Bev. Corp.
Address
Same
City 493919 Zip Tel.
State Lic. City
& Classif. 493919 Lic. # 1231
Arch., Engr.,
Designer
Address Tel.
City IZip 1State#
LICENSED CONTRACTOR'S DECLARATION
I heretry affirm that 1 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 forceand
effect -
SIGNATURE DATE
OWNER40JLDER DECLARATION
I hereby affirm dud 1 am exempt from the Contractors License Law for the following
reason: (Sec. 7031-S,9hsihess and Professions Code: Any city or county which requires a
Permit to constrict, afar, irpove, dtnoislh, or repair any structure, prior to Its issuance also
requires the applicant for such permf to No a signed statement that hes licensed pursuant to
the provisions of the Contractors 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 cirri penalty of not more bran five 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, Busness and
Professions Code: The Contractors License Law does not Wpfy to an owner of property who
builds or improves thereon ad who does such work himself or through his own employees,
Provided thal such irpommeras are not Intended or offered for sale. t, however, the building
or improvement is sold within one year W conplmon, the owner-bu der wig have the burden
of proving that he old not brad or reprove for the purpose of sale.)
❑ 1, as owner of the properly, am exclusively contracting with licensed contractors to com.
struet the project (Sec. 7044, Business and Professions Code: The Contractors License Law
does not apply to an owner of property who dads or improves thereon, and who contracts for
such projects with a contraclar(s) licensed pursuant to the Contractors License Law.)
❑ 1 am exempt under Sem n, & P.C- for this reason
Date 3/r J Owner / • 1. i r
WORKERS COMPENSATION DECLARATION
I hereby affirm that 1 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 cempany
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICTE OF EXEMPTION FROM
1MORII�IIS COMPENSATION INSURANCE
(This section need not be completed i the pend is for one hundred dollars ($100) vatuation
or less.)
I certify that in the performance of tfg 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
Dateowner
NOTICE TO APPLACAW. I, after malting 'its Certificate or Exemption you should become
subjectto the Ubdkers' Conpansation provisions of the tabor Code, you must forthwith
comply with
such provisions or this pend shalt be downed revoked.
CONSTRUCTION LEADING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (sac. 3097, Civil Code.)
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 18D days -
I certify that 1 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 appliDate
Mailing Address
City, State, Zip
No. 46832
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number Tract 22982 - Phase IV
Legal Description JActus Plover
Project Description Plata 5A «&Lot 0.5
REMARKS Yh{r .'',.. n,f.n.. Int r_s.5 A., h
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 DATE INSPECTOR
Issued by: Date 1/10/90 Permit
Validated by:
Validation:
Sq. Ft. 21.34
Size
No.
Stories
No. Dw.
Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$113,413
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
/•�L
Const.
R'3 Si
Mech.
ra T. 55
Electrical
i
Plumbing
13b. til
S.M.I.
7.98
Grading
Driveway Enc.
Infrastructure
�u • ��
TOTAL
_$47M.
REMARKS Yh{r .'',.. n,f.n.. Int r_s.5 A., h
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 DATE INSPECTOR
Issued by: Date 1/10/90 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® E
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
ER OR SEPTIC
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
S (ROUGH) S'
�ER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN
SQ FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
P
/
FRAMING / (� 0 FINAL INSP. 1 qI cl
FLOOR DRAIN
MECHANICAL FEES
�J
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOHDISH)
APPLIANCE DRYER
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,
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
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 TLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACKROUND
PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
ER OR SEPTIC
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. (L��
S (ROUGH) S'
�ER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.-cu.
2 ulgT
P
/
FRAMING / (� 0 FINAL INSP. 1 qI cl
ROOFING ��
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHINGTZ-5 !�
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION (� L
CERT. OCC.
Ccurc Giuei
�J
REMARKS:
SIGNATURESIINITIALS
GARDEN WALL FINAL