10681 (RR)I
Building
Address
Ownerl
J .�
Mailing I
Address
City
. eil 0
4
P.O. BOX 1504 JLJ f }
49-080.Zs~,c?I''OT't' 7&105CALLEESTADO,
LA QUINTA, CALIFORNIA 92253 t`
L cZls e
Zip
LaQuinta 92253
& Associates Roof,
�72-711 Ra3i1031 Rd V"I
City IMP
3.000 Palms 92276
State Lic.
& Classif. 355646
Arch., Engr.,
Designer
Address
564-3100
568=9369
Lic. # . 278
Zip (State
Lic. #
LICENSED CONTRACTON'SMECLARATION
I hereby affirm that I.am licensed under provisions of Chapter 9 (commencing with Section
7000) of DlOW& 3f,.the Business and P11�BB
rofessio Code, and my license Is In full force and
I-. act. /
�"OGNATURE +' , DATE
OtMNEIFBu1LDER DECLARATION
1 hereby affirm that'1 am exempl4rom the Contractors License Law for the; following
reason: (Sec..7031.5,I3usinesa- and Ptolesalana Code: Any Guy or county which requires a
permit to construct, alter, Improve, demolish. or repatr any strucboe, prior to its Issuance also
requires the eppficant for such paimit to elle a atprree statement that he Is licensed pursuant to
the pro of the Conbactors t.lcenso Law, Chapter '9 (cmrrnenclrg with Section 7000) of
Division 3 of the lilrshlees Arid Professions Code. or that. he Is .eitempt tha:e/roan. and -the Nests
Air the alleged exemption. AnyYlGetbn of Section 7091.5 Dy 'mrIF apptkant for a permitsub)ecis the 'spplkant to a civilperoafty of not more then five hundred dooms (5500).
0 I, as owner of the,property, or my employees with wages as theirsole compensation, will
or
do the work, and the structure Is not Intended ooffered for sale. (Sea 7044; Bulaness 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 ft own employees,
provided ,that such _Mprovements, are riot Intended or offered for sale. ff, however, the building
or improvement is sold within one year of completion, the ownerbuilder wID have the burden
. of proving that he did not build or kwmve 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 arta Professions Code. The Contractors License Law
does not apply to an owner of property -who builds or Improves thereof, and who contracts for
such pro)ects,with a contractor(s) licensed Pursuant to the Contractors 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'certifled copy thereof. (,Sac. 3800, Labor Code.)
Poll No. Company-
ICopy is filed with the city. ❑ Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
(This section need not be completed If Me po-* hi ,for one hurudred doilare ($100) valuation
or less.)
I certify that In the performance of the work for which this permit Is Issued, I shall not
employ any pereon in any manner so as to become subject to the Workers' Compensation
Laws of California
Date Owner
NOTICE TO APPLICANT. N; after makhg M. Certificate of Exempsan you should became
subject to the Workers' Compensation . provisions of Me Labor Code, you must �forMwtth
comply with such provisions or this permit shell be deemed revoked.
CONSTRUCTION LENDING AGENCY
1.hereby affirm that there is:a construction lending agency for the performance of the
worts for
which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Addres
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..
1 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. 10661
BUILDING'- TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
1-r",i;1 C.
Project Description
a'�IOCf ¢-. -
Sq. Ft. No.
Size Stories
No. Dw.
Units
'New ❑ Add ❑ Alter ❑
Repair ❑ Demolition..❑
Estimated Valuation 3 ` 8 00
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
2-0 01,0
Mech.
Electrical
S.M.I.
-Grading
Driveway Enc.
Infrastructure
TOTAL ;4U. U
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:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
c
2ND FL SQ. FT.
SLAB GRADE
YARD SPKLR SYSTEM
POR SQ FT ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ FT ®
POWER OUTLET
ROOF DRAINS
SEWER OR SEPTIC TANK
DRAINAGE PIPING
CAR P. SQ. FT. ®.
DUCT WORK
ROCK STORAGE
WALL SQ. FT.
DRINKING FOUNTAIN,
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION 5
REINF. STEEL
WATER PIPING
NOTE Not.to be used'as.property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FINAL INSP.
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, TEMIPERM
LAVATORY
HEATINGSYSTEM- FORCED ' GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U..
SQ. FT. ® c
BATH TUB
REMARKS:
SQ. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B•T.U.
SQ. FT. RESID ® 114 c
SEWAGE DISPOSAL
SO.FT.GAR ® ific
HOUSE SEWER
FIREPLACE
GAS PIPING
PERMIT FEE
PERMIT 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 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 APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xE
=S
LUMBER GIL
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
/
REMARKS:
li a
VENTILATION
et
5 t1�
FIRE ZONE ROOFING:
FIREPLACE
dAkAtN
17 3
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
p�
FINAL INSPECTION • 3 _ / 3
CERT. OCC.
FENCE FINAL
INSPECT'OR'S SIGNATURES/INITIALS
GARDEN WALL,FINAL
Building
Address
tars vn�cc w nw
6"9-080 Eisenhower LA OUINTvwA, CAUFORNIA MW f
same
LaQninta ZIP 92253_ r-564-3100
Denny b Associates Roofing
Adz 711 Ralson Rd #1
1000 Palms 92276 568-9369
State Lic.City
a, cla8sit.., 3SS666 C # 278
Arch.,, Engr ,
Designer
Address Tel.
TJp State
Uc. #
LICENSED CON RACTOWS,OEClA11AT10M
tra" affirm that l am Iloerraed under Chapter 9 (oommsrlcing with Sedlon
Of oiv(s on 3 of the and and my license Is In full tome and
NATLW
0111NER4eIL081 DECLARATION
1 hereby oftirin tires 1 am exempt from the Oontractore Ucense law for Ola, fallowing
reason (Sec: 7031.5,ftaftgss a a fnstessOab Cods: Ary adz or ovary abblr reprise a
pemrlt b oonobua, ater. IspOea, 0, , - I or ropes• aayy sbr��reaee, pArr'b b treiarsos oho
regrbee ar aPPtbaar for area Permf m lis' a a�fr0 ebdement art M b Ybwred parmnf to
On prortr n, d ala Costrarlwri 1bwMe 1s, O01010110,'0 i we Babson AM) of
pveebn 3 d Oio B�elIdes and mobsalorreCbA4 ai fbst..he b -avow faeve/rom And"how
IN" ;
": asreparL Aey riotrtbe d tDsoaon 7031.5 by try Nor a pon,
asOrecEs Ove b a eMpar4 dnas rmra lM Ow ArobeO do4refia0o6 -
❑ 1, as owner, of tho property, or my employees with wages as fhelr ads conparmetlo % will
do the work, mW to atruetuse Is not Intended or ansae for tele. (Sae. ?Ori; arotursss ani
Rwfeedbre Code: The Coneaeamis IA+seee Law dose not gply b an ovwm d pwpeny iso
budds or aprowla Strome aM afro does such w * himself or arovrfr els oan eapgsee
pro►rded riot suds ,aproswrraue.are nOt irird�d or aflbiee br awls B0 Nowrnar JNs Orump
or hPro►inowd: 'BLOW SIN ons yearof ompl 0 Or Omw4vider r lmn "bun"
Of pvoaerp feet ae d1d got bulla or hpeve br Ole papoev d aim
0 1, as owner of "property, arn.mtoluNv�rOorlbrctlrlg sllh Bosnsed oorrI M."re to om►
elfuct the prMOM (Sec. 70I ,avolo ea awl Raesssbse Gloats TAs QrWadm>e lloensp law .:
dbw not �oPy b 4 owner d propwy NIO baits or srporos aarsan, and -vols ponbeofs bi
ewer praede wile a asrv6ae/wjal iomisadpvaaueM to Ors CenbaploAs tresses tsJ'
O 1 am exempt unit Sec_.. - st,a m ford" reason
Dots owalar
wOR11�RRffi COMOMT10N OECLARATIDM
affinn. Vast I have Worker'p 1 voe ar oUaereof�. p3seS000. L«ebasr aaode�) sol.
Poi No��Cpnpany
C.
Copy lo filed with Uva sty. ❑ Cstltlad Dopy fs hereby turrrlstred.
CERTIFICATE OF E>MYP IMI FFAM
WORKERS 00111FEWAT M 9I911RAlICE '
(n* seedon need not be omrpI, 0 she pemrd is b► am avnbed defws (8100) watadlav
Orion.) , pamdt
omPloY any, tpheartaoln Ithe performance pPthp work for W fha workers'ad Ot'
Compeneation
Laws of Celifomla n any'rnanner so as to beognae
%;� Awvvar
a 7o APPLICANT.- C", aeaer aaAtq Oys Cmtdtuaee of Bompelon you ssmdd becune
ereisor to tae Rbrksm' Caerpeevaetbn prosI I , d Ore laser Coda, you must *rano
*amp* we subs provfabpemv
ne or Ode f aw be dsae sd rwrw/sd.
001111 UCnOM LENDIMI AtIEWY
!-hereby haffirm dial there Is a copatruetion lend nil apwaoy for ft perforrraence d the
wok for wAdc this port is Issued. (Sm 3007, tis/ Gbds.)
Lendoes llama
Lenders Address
This is a building permit w111911 filed out, egrled and validated, and Is Kelect to
expiration f work Ovaeunder la mop eMad for IN days
1 oerilh that 1 have read this application wW stale OW the above lift.. an le,eonac
agree fo comoh with a►1 ��f1yty old cbamgr ordirgnoas and atala taws relatlivp to building .
end her0y. aw"WIN aepresordatives of Ods city to enter the above. .
nrntlorled propeAy far InepeeHon purpoeea
Signature of oppUmvt esti
Melling aeere.a
city, stats, rM
BUILDING:. TYPE CONST. OCC: GRP.
0.P. Number
Legal Description
Project Description
Re -Roof
Sq. Ft No. No. Dw.
Size Stories : = Units .
New ❑ Add ❑ After ❑ Repair ❑ "Demolition u ` -
IVIAL
-I
dimated Valuation
3, $00
PERMIT
Plan Chk.. Dep..
y{�wr,uT
Plan Chk. Bal.
Const_
20.00'
Meeh. . .
BY:
Electrical'
Plumbing
_
Rear Setback from Rear Prop..Une
Grading
..s 4
Dd eway Enc:.
'
Infrastructure
Issued by:
ngra h
IVIAL
-I
REMARKS
ZONE
BY:
Minimum.Setback Distanoem
Front Setback from Center Una
Rear Setback from Rear Prop..Une
Side Street Setback from Center Una
Side Setback from Property Una
FINAL DATE
INSPECTOR
Issued by:
ngra h
validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBI
►,�
IST FL SO. FT. O f
UNITS
'
x
2ND FL SO. FT..O
YARD SPKLR SYSTEM
POR ®
MOBILEHOME BVC.
BAR SINK
GAR SO. FT. O
POWER OUREf'
ROOF DRAINS
CAW P. SO.,FT. O
GROUND PLUMBING
DRAINAGE PIPING
WALL. so. Fr.
COLL,•AREA
DRINKING FOUNTAIN,
SO: FT. O.
SLAB GRADE
URINAL
ESTIMATED CONSTRUCTION VALUATION i
BONDING
WATER PIPING
NOTE Not to be used aspopoty laic whmtlon
'
FLOOR DRAIN
MECHANICAL FEES
SEWER OR SEPT10 TANK
WATER SOFTENER
VENT SYSTEM FAN EVARCOOL HOOD
SIGN
WASHER(AUTOI(DISH)
APPLIANCE DRYER
GARBAGEDISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
HEATING (FINAL)
LAUNDRYTRAY
AIR HANDLING UNIT CFM
t
OTCHEN SINK
ABSORP I ION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TE FPERM
LAVATORY '
HEATINGBYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SM FT. O c
BATH TUB
SG. FT. O, c-
WATER. HEATER
MAX HEATER OUTPUT. &TAL
SO: FT. PAM O 1% a
SEWAGE .DISPOSAL
SOFGOARO'Ac
HOLE SEWER
FINAL 1NSP.
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
- .MK:HO FEE
MECH.FEE PL.OLFEE
CONST. FEE ELECT. FEE
J
SMI FEE PLUMB. FEE.
GARIQM WALL FINAL
I
--STRUCTURE
PLUMBING
ELECTRICAL
HEATINGL4AIR COND.
SOLAR-
'
x
_
SETBACK
GROUND PLUMBING
UNDERGROUND -
A.C..UNIT_
COLL,•AREA
•
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK;
'
FORMS
SEWER OR SEPT10 TANK
HOUGH WIRING.
-DUCTWORK
ROCK STORAGE
i
- 1
FOUND. RENF.
GAS (ROUGFQ
METER;LOOP
HEATING (FINAL)
OTHER APPJEG)P _ ''
t
REINF. STEM
GAS (FINAL)
TEMP. POLE
'
i
"GROUT.-
WATER. HEATER'
SERVICE
FINAL INSP.
_ .
BOND BEAM
LUMBER GR• -
FRAYING
WATER SYSTEM
r
GRADING ' lit X "
i ploe d =S
FINAL 1NSP.
FINAL INV.
ROOFINLI
VENTILATION
FIRE SONE ROORNG :
_
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING
MESH
B18ULATOWSOUND
FINISH GRADING
FINAL BiSPBCTION
CETT. COC .
—
REMARKS:
D
�
0V� v. c O
I T d 6 f TYI
t.
3
GARIQM WALL FINAL
I