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001710 (BLDG)Building Address 77-550 e Owner iSAl9. IMd Address P.O. BOX 1578 Tt, IOU 4ht 4 Q914A P.O. BOX 1504 N o . 78-105 CALLE ESTADO C3 LA QUINTA, CALIFORNIA 92253 CityZip Tel. . �i�atn 93923 56 "446 , - Contractor .. Ludwxk Lard Omst. 03�. Address City Zip Tel. Tia► 01inta 93923 345-28% _ State Lic. ICity & Classif. 413636 Lic. # Arch., Engr., Designer Ai 7>�rs Address//�� qq���� Tel. P. City Zip State r<1kl�ir 13��3 Lic. # C14006 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 Busihbss and Professions Code, and my license is in full force and effect. �� O:d�ar. �/C,i, �+'✓f r..fr: Jc'... SIGNATURE DATE r- -OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractoes'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 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 thathe 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). ❑ 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. 4044, 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 sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that -h - e did not build or improve for the purpose of.sale.) ' ❑ 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 coniractor(s) licensed pursuant to the Contractor's License Law.) - 0.1 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 ' O 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 permit is for one hundred dollars ($100) valuation or less.) » I certify that in the performance of tha work for which this permit is issued, I shall not +employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become subject" to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) . Lender's Name Lender's Address This isa building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to -enter the above- mentioned bovementioned property for inspection_ purposes. Signature of applicant Date Mailing Address J A City, State, Zip / HARD COPY 001710 BUILDING: TYPE CONST: V OCC: GRP. A.P. Number 052 P 001, .002s003sO4 Legal Description Project Description T.A 01inta Golf nlll�� suncu= ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Sq. Ft. B%5450 Size R7n- No. Stories No. Dw. Units NewSO Add ❑ Alter ❑ Repair ❑ Demolition ❑ FINAL:DATE INSPECTOR Issued by: Date$ Permit Validated by: Validation: A 2 6 0 7 9 16 1899,47. R Estimated Valuation 150r4O. PERMIT AMOUNT Plan Chk. Dep. 600.00 Plan Chk. Bal. 358.00 Const. _ 31„00 Mech. 135.04 Electrical 95.00 Plumbing 10.47 S.M.I. Grading 20.00- 0.00.Driveway DrivewayEnc. 11050.00 - Infrastructure TOTAL 2.4".e147 1.899.47 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 FINAL:DATE INSPECTOR Issued by: Date$ Permit Validated by: Validation: A 2 6 0 7 9 16 1899,47. R 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. SQ. FT. @ POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I 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 FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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 @ 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./EQUIP. 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 SIGNATURES/INITIALS, GARDEN WALL FINAL rfl�i�zTVrtAL �W�2.S -� l o�N. I�(P,I�w�k�;b IVa✓. C714) 883-49774- !-� �uinit� MaN'�t.1gNG6 �n�� 5....:CEIVED Jnr. ---r -----------McCORD & WALD PALM SPRINGS p4K(r, - $ -85 J�Nn goal ON= 17,0. . I:� 4 Tre1155 t -I'm U — ACTUw!rZw_ . , Of 9'e'. � w �t—A L, 14' w foo*1I N1- lot, Y- l 4- bF ► r K G0 ao*tt pts i 41 Essi �`c• Q,RID C. F � � l IS 1 z �.-$ r 3077' Wiz.- I,to�. ; M = 15'- �'� 7o8 ; As�- 1.�8(I G .t.P ... .. .... fi -C1V1-VV -- . �aF of CAS: �-4-�__...�'...._........:.'_...._ _._... _... _ ._._.. l ( AT&2AL- C ) bd= qty,=, ►8��4ox2�). 20'� 114- iii, a moo' 19-x.... ?.cam 7 / /. qvo //j ¢ao Gjoc� vr, 2-f2 / o d /VA . 3 ��%i 6� / 2 /c. CldU--2 .4&(-, Qom. be "�o' "/ ff o,2 " �� t /v �o5is _ . _ ._ ._..._..__........ _._....... ..... ....__..._... tow�y as pwi � W/ rod �w,or�. u,vs✓-s ��' s � o � 7 , 1 t4 d o(, ,� roc,r�� �� u "c�� IN. /o, 30 , L uatl3: G r �. ®� 9,347 t/AGL L/1J:� �� Ll,�'�'� O � ®---- ��✓/� / % �� STiJc�o wl' s/����5 /ams ' / o d /VA . 3 ��%i 6� / 2 /c. CldU--2 .4&(-, Qom. be "�o' "/ ff o,2 " �� t /v �o5is _ . _ ._ ._..._..__........ _._....... ..... ....__..._... tow�y as pwi � W/ rod �w,or�. u,vs✓-s ��' s � o � 7 , 1 t4 d o(, ,� roc,r�� �� u "c�� IN. /o, 30 , L uatl3: G r �. ®� 9,347 t/AGL L/1J:� UNDERG2 GOND TANK, 7 -RIM FDR GASOL 11VE WITH 001/ RLE WALL iAN� - 2. 53 PA? -- /'/L.. 6,411. Ftogr VALVE -L ryl4ivNn4c _. :. .. %. L/145 -'F" FML RoifPY-aA[ (C.33T-4 -SU C 77DA/ pUAlp 8. /!/ Pp/►gFCo 4OV41CSP11-C. doX wfrV F/tc CAA .rf +,D4Al'dC 9. �ir —ORePTt4,6E Z�9 G ..._ ._..; .. ...: __..._ ..... ! (, JRLV. I�IpE (Foie P17sr�uCT GI,v'E 1F- r/EwT �! UEG/SIG -ST T/on/ S'C/�EA'1.4T/C . ' t.� Qyc� IwrT/4 N TF eClc iYf IV,v 7'• E AA'eE .1314000 _._APAAJ_ i a Lcoe S� i : -' - - • - -... __ ..... ..� ..... , - , _ _1_ .. _ .s...�__:_ o.NL' G lel- - - -- - -=',ti::��- =, t .P t' 1' , { - 7' .-� - - -- --•-- -� -- ---- ------ -- ..... . ........ ......._------ 4 P.O. BOX 1504 APPLICATION ONLY Building 78-105 CALLE ESTADO Arirtrass LA QUINTA, CALIFORNIA 92253 Owner ell, o Mailing n Address ASOY 1� A City, Zip Tel. _61 m4 �3��3 Sly/ , (/(/(5:, Contractor Li' 41,6 A"J7.Q e -r . Address City Zip1� y� 52 3 Te� yS - 2 ?k State Lic. & Classif. y� 3� 3 6 City Lic. # Arch., Engr., Designer Address TTel. City Zip State 1e' ao/w 7,o���r Lic. # iy�6 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) t. of Division 3 of the Business and Professions Code, and my license is in full force and effec SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, eller, 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 Cade, 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 penahy of not more than five hundred dollars (5500). ❑ 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 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 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 or 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 builds or improves thereon, and who contracts for such pro/acts with a contractor(s) licensed 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 permit is for one hundred dollars ($700) valuation or less.) I certify that in the performance of thg 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. Date Owner NOTICE TO APPLICANT., If, alter 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. 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.) Lenders 'Name Lender's Address 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. 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 BUILDING DIVISION BUILDING: TYPE CONST. -0 OCC. GRP. A.P. Number # 773(1)-.-72 3%1..2 t'15� C11x?' Legal Description'/0 7' /3, i; /. ,LA T u/!ir Project Description 1a f,?i'i.r��i (0/7� /%2•�i/�Tr/�ti�vCE �triLG'; Sq. Ft. P D 10 No. / No. Dw. 4.1;Size C Stories ' Units New4 - Add ❑ Alter ❑ Repair ❑ Demolition ❑ 77L6 Estimated Valuation PERMIT AMOUNT Plan,Chk. Dep..- Plan Chk. Bal. Const.- C3S­0 Mech. — Electrical 5 - Plumbing S.M.I. Grading Driveway Enc. Infrastructure acoo, 2!yn 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 FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: A 1 7 5 5 6 26 600.00 CK CONSTRUCTION ESTIMATE GROUND PLUMBING UNDERGROUND NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. d00 SO. FT. ® Q $ .CiI Q, BONDING UNITS STORAGE TANK FORMS (y 2ND FL. Q SO. FT. ® 1- L S 1 on ROCK STORAGE FOUND. REINF. GAS (ROUGH) YARD SPKLR SYSTEM HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL GAS (FINAL) MOBILEHOME SVC. BAR SINK GROUT POR. SO. FT. ® SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GAR. SQ. FT. ® _$ LUMBER GR. POWER OUTLET FINAL INSP. ROOF DRAINS FINAL INSP. ROOFING DRAINAGE PIPING CAR P. SQ. FT. FIRE ZONE ROOFING WALL SQ. FT. FIREPLACE DRINKING FOUNTAIN SPARK ARRESTOR SO. FT. ® GAR. FIREWALL URINAL ESTIMATED CONSTRUCTION VALUATION $ I q(4 XOO WATER PIPING INSULATION/SOUND NOTE: Not to be used as property tax valuation FINISH GRADING FLOOR DRAIN MECHANICAL FEES CERT. OCC. WATER SOFTENER FENCE FINAL VENT SYSTEM FAN EVAP.COOL HOOD G SIGN WASHER(AUTO)(DISH) GARDEN WALL FINAL 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 '% OQ AMPERES SERV ENT `00SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER S MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE 0G PERMIT FEE to PERMIT FEE to DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE `� 1 SS I k 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