05596 (BLCK)Tlihf 4 4 a"
P.O. BOX 1504
Building _ 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner Western Am>Cican Construction
Mailing B1379
Address P.O.
City Zip Tel..
La Qtafats 1 92253 1 619/564-7412
Contractor
Gaxq Reynolds
Address.
Sam
Tel.
State Lic. City
1£ Classif. 469157 - $ Lic. # 1.1.14
Arch., Engr.,
Designer, Rd Diaz
Address . - Tel.
City..- (Zip (State I
Lic. #
LICENSED CONTRACrOWS DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business arta de, Professions Coand my license is in full forcerand
effect r 7
•DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Busi7ess and Professions Lode: Any city or county which requires a
permit to construct, after, improve, derhplsh, or repair any structure, prior to its issuance also
requires the applicant for such permit to ft a sigrfed statement that he is Licensed pursuant to
the provisions of the Contractor's license taw, Chapter 9 (commencing with Section 7000) of
Dh4sion 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alfeged exemption. Any vkNatimr or Sermon 7031.5 by any applicant for a permit
subjects the applicant to a civil penally of not more than fire hundred dollars ($500).
0 1, 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 intended or offered for safe. ff, however, the building
or improvement is sold within one year of compitition, the owner -budder will have the burden
of proving that he did not build or improve nor the purpose of sale.)
❑ 1, 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 bu kis or k iproves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. R. & P.C. for this reason
Date owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent.AWo- lf-insure, or a certificate of
Worker's Compensation Insurance, or a certified copy,thergo� . 3800, Labor Code.)
Policy No company y'`
❑,Copy is filed with the city. ❑ Certified copy is" hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(chis section need not be completed ff the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of the 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 y
Date Owner '
NOTICE TO APPLICANT: ff, after maldhg'diis Certificate of Exemption you should become
subject to the Workers' compensation- provisions of the labor Code, you must forthwith
LbrnplY with such provisions or this Permit shag be deemed revoked.
CONSTRUCTION LENDING AGENCY
1hereby 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
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 100 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. 05596
ILDING: TYPE CONST. OCC: GRP.;
Number
774-224-011 and 012
Legal Description
Project Description Retaining lull
60 feet by 2 --foot high
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$5500160
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
15.€ 0
Mech.
Electrical
Plumbing
S.M.I.
.0
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
1'h-03 IV
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
4/4/89
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST 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. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT. ®
GROUT
HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to he 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
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
LATHING
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.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 GOND. 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./EQUIP.
C
LzEINF. STEEL - !
GAS (FINAL)
TEMP. POLE
GROUT
HEATER
SERVICE
FINAL INSP.
/WATER
G OND BEAM G - /a _ P-57
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 SIGNATURES/INITIALS
GARDEN WALL FINAL