14448 (SFD)Building
Address
Tay/
9��N
1 X
P.O. BOX 1504
50-44 5 ' Grand Traverse78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
La Quiriaa Fairways
Mailing 355 uristol 5t., Ste. A
Address
CityZip ITel-
Costa
Masa, Q 32625 4710540-6064
cg�n,,tra%tlu Group .
Address
City lZip I Tel.:
State Lia B613161 ( City 3324
& Classif. Lic. #
Arch., Engr.,
Designer Danieliari AssocfidteSi
A�dresty
Corporate Fars (67'10 474-6030
Ci y Zip State
wine,.*, QA_�...,, • 92714 Lia #
+ I \LICENSED CONTRACTOR'S DECLARATION
I hereby 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 force,and
effect. i� 1 r(- 1 0,._ - _ 7 F 'k ii* 'Yr
-OWNER-BUILDER DECLARATION
.0 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, alter, 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
_ 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 or not more than rove hundred dollars ($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 Contractor's License Law does not apply to an owner or property who
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.)
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 contractors) [censed 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 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
❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the , permrit is for one hundred dollars ($100) valuation
or less.) F k t
I certify that in the performance•of thg work for which this'permit is issued, I shall not
employ any parson in any manner so as to become subject to -the Workers' Compensation
Laws(of California , j
Date i'_ir"yi�Owrier �k It_.%,• ..
NOTICE TO APPLICANT: M, 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 shall be deemed revoked.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
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,
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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 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 purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
No. 14448
BUILDING: TYPE CONST. CC. GRP. R3
769 -f. -n41111 0-
-
A.P. Number 3
Lot • 2 Tract 25389-1
Legal Description
Project Description SFD}an 1
La Quinta Fairways
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Lir
Rear Setback from Rea �r
Side Street Setbackf( m den
Side Setback fr9m Property Li
FINAL
Issued
Validat,
Validat
Sq. Ft. 2316
Size
No. No. Dw.
_ Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
4;191i129.00
PERMIT
AMOUNT
Plan Chk. Dep.
& 14
Plan Chk. Bal.
_
Const:
Mech.
Electrical
�� •
Plumbing
l •
S.M.I.
•
Grading
• U
Driveway Enc.
• VU
Infrastructure
87.
ria t1!. PE[bl
U FtZiCUZ 2 27 • KY4
TOTAL
+► u •
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Lir
Rear Setback from Rea �r
Side Street Setbackf( m den
Side Setback fr9m Property Li
FINAL
Issued
Validat,
Validat
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBIW FEES
IST FL." SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. S0. FT. @
FORMS
SEW OR SEPTI
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
FOR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SO. FT. ®
GROUT
WATER HEATER
WALL SO. FT. ®
FINAL INSP.
DRINKING FOUNTAIN
BOND BEAM
WATER SYSTEM
URINAL
SO. FT. ®
=$
LUMBER GR.
ESTIMATED CONSTRUCTION VALUATION $
FINAL INSP.
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
VENTILATION
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIRE ZONE ROOFING
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIREPLACE
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.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
MIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE EPL.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
SEW OR SEPTI
ROUGH WIRING
DUCT WORK
ROCK STORAGE
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
-
GARDEN WALL FINAL