05256 (RPL)Aa�idpTg 49-130 Fiisenhaver
Owner
c&ht 4 4v Qf4
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
& Mrs. Frank 01
Address Sage
City Zip Tel.
La Qui nta 92253
Address
45-11 U. Suuny runes #A
State Lic. City
& Classif. 'Al 7 b Lic..#
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LIQ CONTRACTOWS DECLARATION
I hereby affirm than I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the'Business and Professions ode, and my license is in full force and
effect �/ .e _
SIGNATURE DATE
OWNER WRE ER DECLARATION
I hereby affirm that I an exempt from the Contractors License taw for the following
reason: (Sec. 7091.5.&mhess and R ofesudons Cods: Any dly or county which requires a'
perndtto CM0,4 aMff. Ja*W ulemwisP. or repahr any structure. Prior to Its issuance afso
requires aWo �an Casci r Uc law, chapter comrnennrng wfh of
Me pmvftvm o
Ohdsfoh 9 of. the Business and FloAmfta Code, or that. he is exempt fhoWmm. and the bass
for the aft ed exenptbr. Any rioI inion of SecMn 7031.5 by 'any applicant for a pend
subjects the appftwd to a emparzW ofnot mare dw The hundred dooms ($500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not Intended or offeredfor sale. (Sec. 7044, t4dwuess and
Professions Coda: The ConinacEng License Ler does not apply to an owner of property who
bubo or hpmves thereon and who does such work hsaet or through his own en{pbyess,
provided tit• such irpovemsrm are not intended or offered for safe.. h however, five buffing
or inprovenwa is sold within ane yarn of compilation. the owner -badder will have the burden
of proving Mat he did not buil or igwom for Me purpose of sale.)
0 I, as owner of the property, am exclusively contracting with licensed contractors to con -
swot the project r.W— 7044, Business and Rofesalons Code. The Contractors License Law
does not appy to an owner of pmepedy who builds or bnprovss thereon, and who endracts for
such pnoacts w@h a conbaclbr(s) Scanted pureed to the Contractor's License Law.)
❑ 1 am exempt under Ser r & P.C_ for this reason
Date Owner
WORKERW COMPENSATION DECLARATION
1 hereby affirm that 1 have a certificate of consent...to self -Insure, or a certificate of
Workers Compensation Insurance, or a certified copy.tha�L.(Ssc. 3800, Labor (ode.)
Poliq'No. Company ,1�-' -
El Copy is filed with the r;ity. ❑ Certified copy Is hereby furnished.
c13MFICATE OF EXEMPTION FROM
W COMPENSATION INSURANCE
(rhe section need not be completed # the pomd is for one hundred dofars (8100) vabaUon
or Mss.) .
I certify that a oInn mor
the pedoefae of the wk for which this permit Is Issued, 1 shall not
gip$ (annyllperson In any manner so as to become subject to the Workers"Compensation
Date pwner
NOTLCE 70 APPrJr.AMT: if, after nabkg this Cerfilbsto of Lismpton you should Deecros
subject m Che Waders' CoopansaBaw pmoeslmms of Me Labor Codeyou moat forMmviM
comply -withauchprovisions orMfspondsuntbe,downed revoked
.
CONSTRDCr10N LENDING AGENCY
Thereby affirm.that there is a construction lending agency for the performance of the
work tor.wldch the permit Is IssLmNL (Sea 3097, Clef Code_)
Lenders 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 180 days.
1 certify that I have read Weapplication and state that the above information is correct.
1 agree to comply with all city and county ordinances and state laws relating to building
mentioned
property
f pection pufives of this city to enter_ the above..
Signature of applirwrrt Date
Melling AddrPsa
City, State, Zip
No. 05256
BUILDING: TYPE CONST: OCC: GRP.-
A.P.:Number Calf Estates
Legal Description
Project Description Pool & SiPg
r
Sq. Ft.
Size
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$ /f
Const.
Mech.
3 a. na,
Electrical
Plumbing
O
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
t 1
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 113 18 9 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO: ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® i
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR SO FT ®
DUCT WORK
ROCK STORAGE
GAR. SO. FT. 0
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
DRAINAGE PIPING
CAR P. I SO. FT. ®
GAS (FINAL)
TEMP. POLE
WALL SO. FT.
DRINKING FOUNTAIN,
GROUT
WATER HEATER
URINAL
SO FT a
FINAL INSP.
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd:
plus x5
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
LAUNDRY TRAY
AIR HANDLING UNIT CFM
VENTILATION
KITCHEN SINK
ABSORPTION SYSTEM B.T:U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEWPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
GAR FIREWALL
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11A c
SEWAGE DISPOSAL
SO.FT.GAR ® 3IAc
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 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.
REIN F. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
g
GRADING
cu. yd:
plus x5
=E
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING
MESH
INSULATIONNSOUND
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINRIALS
'
GARDEN WALL FINAL