9522 (GRES)o
Twi
K
ABu"ding 47-660' Eisenhower
ddre
Owner
14r..Paul Hansen
Mailing
Address
City Zip.
La Quinta 92253
P.O. BOX 1504
78.105 CALLE:ESTADO
LA QUINTA, CALIFORNIA 92253
Contractor I
owner/Builder
& Classif.
Designer
Address
Lic. #
.City Zip State
Lic. #
LICENSED CONTRACTOR'S.DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 8 (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
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: .(Sec. 7031.5,Sua6rees and Professions Code: Any CRY or county Ivhlc/h requires a
permit to construct, after,' Improve, demolish, orrrmfi to Me a signed a
repair any structure, prior to Re issuance also
ent Met he is licensed pursuant to
provisions f the Contractor'sres the appikumt for s License Law, Chapter (comrnomft W7000) of
Division 3 of Me 'Business and Professions Code, or that;he is exempt therefrom, and Me bass
for the alleged exemption. Any violation of Section 7031.3 by 'any applicant for a permit
subjects the applicant to a cIW penalty of not more then live hundred dollars (=500).
cqAas owner of the property, or my employees with wages as their sole compensation, will
db'the work, and the structure isnot Intended or offered for sale. (Sec. 7044, Suisness and
Professions Code: The Contractor's License Law does- not apply to an owner of property who
bulfda or Improves Maroon and who does such work himself or through his own employees,
provided that such knpmvem ffls are not Intended or olfered for safe. 9,, however, the budding
or improvement is sold within one year of compist/on, the owner-buddbr will have Me burden
of prov/ng 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-
struct -the project. (Sec., 7044, Business and P.rofesakma Code: The Contractors License Law
does not apply to an owner of property -who builds or Improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. S. &"P.C. for this reason
!r
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that l have a oertificate.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. O Certified copyls hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This secton need not be completed If the permit /s for one hundred dollars (5100) valuation
or lose.)
I certify that In the performance of tbg work for which this permit is Issued, I shall not
employ any ppeereon in any manner � tto beck object to the Workers' :Compensation
Laura of Cailfornia. f s
Date Owner /
NOTICE TO APPLICANT: lf,� raking this rti fcate o1 Exemption you should become
subject to the Workers' ensaflan provisions of Me Labor Code, you moat forthwith
comply with such provielons or this perm# shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that there Is a construction lending agency for the performance of the
work for which this permit Is Issued. (Sec. 3087, Civil Code.)
Lenders Name
Lenders 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
No. 9522
BUILDING: TYPE CONST. OCC: GRP.-
A.P. Number
Legal Description
Project Description
Golf Cant storage
Sq: Ft. No. No. Dw.
Size 50 Stories Units
New ❑ Add ❑' Alter ❑ Repair ❑ Demolition ❑
r. 1
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
35.10
Const.
rJ .00
Mech.
Electrical
15.00
Plumbing
S.M.I.
.3G
Grading
Driveway Enc.
Infrastructure _
TOTAL
1043K
REMARKS
., . r.- r h h
i u � Ing h "i '►� {4ii : � 4. 0 `
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
A.C. UNIT
2ND FL. SO. FT. ®
SLAB GRADE
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CARP SO FT ®
SEWER OR SEPTIC TANK
DRAINAGE PIPING
WALL SO. FT.
DUCT WORK
DRINKING FOUNTAIN.
SO FT a
URINAL
ESTIMATED CONSTRUCTION VALUATION Y
WATER PIPING
NOTE Not to be used as property tax valuation
RE1NF. STEEL
FLOOR.DRAIN
MECHANICAL FEES
TEMP. POLE.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
WATER HEATER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FINAL INSP.
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM _ B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM. FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. a c
BATH TUB
%, (�{d Q*
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+A c
SEWAGE DISPOSAL
SO.FT.GAR ®'Ac
HOUSE SEWER
FIRE ZONE ROOFING
GAS PIPING
PERMIT FEE
]PERM R FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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 APPJEOUIP.
RE1NF. STEEL
GAS (FINAL)
TEMP. POLE.
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
i
GRADING
Cu. yd.
Plus x;
=$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING l�!
Ol l ��
%, (�{d Q*
�yGJi�a/1 /�I�'j/�/ L p
REMARK
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HI G L
MESH
INSULAT70NIS0UND
FINISH GRADING
FINAL INSPECTION f+�;
CERT. OCC,
FENCE FINAL
INSPECTOWS SIGNATURESIINITIALS
GARDEN WALL FINAL