11871 (RC)P.O. BOX 1504 No. 11$T1
Building 51-230 EISENHOWER 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
RACK XORR,IS
Mailing
Address tp 0 BOX 1505
City Zip
LA QUINTA 92253
Contractor
RICK MORRIS
P 0 Box 1505
LA QUINTA
State Lic. 48
& Classif.�a&
-- Arch., Engr.,
Designer
Address
City
I hereby affirm that I am
7000) of Division 3 of the I
effect.
Zip
Zip
. 564-2883
Tel.
564-4832
City
Lic. # 626
Tel.
State
Lic. #
CONTRACTOR'S DECLARATION
under proSt'lions of Chapter 9 (commencing with Section
and Professions Code, and my license is in full force and
_SIGNATURE r -- DAT
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or i 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 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 penalty of not more than five hundred dollars ($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 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 of sale.)
O 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 contractor(s) licensed pursuant to the Contractor's License Law.) .
O 1 am exempt under Sec. B. & P.C. for this reason
Date Owner 9
I
WORKERS' COMPEf ATION DECLARATION
I hereby affirm that I have a certificalp o consent o self insure o a certificate of
Worker's Compensation Insurance, or a cert4'ed op t ,eaf-Seo: 9'8'00 -Labor Code.)
Policy No. Company
C}�Copy is filed with the city. ❑ Certif . d copy is hereby furnished.
.ai
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 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, 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 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: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description MINOR REMODEL OF INTERIOR
RESTAURANT
Sq. Ft. No. No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Estimated Valuation $1,999
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const. $25.00
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL 1 $25.00
REMARKS"+C -,-, A S
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
Validation:
1#1
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING F.nl� 1►f'
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
w '
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. 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 lax valuation
FRAMING
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
LAUNDRYTRAY
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
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID a 11/4 c
SEWAGE DISPOSAL
INSULATION/SOUND
SQ.FT.GAR ® 3/ec
HOUSE SEWER
FINISH GRADING
GAS PIPING.
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE IPL.CK.FEE
CONST. FEELELECT.
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
FINAL INSR �3
GRADING
cu. yd.
$ -plus-x$-=$
LUMBER GR.
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
if- PV
i�
xzt
r
TiN of 10 utnta
�
ut�tn �tn'ne 3441b5thill
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
BUILDING ADDRESS
51-230 Eisenhower
Use Classification Restaurant Bldg. Permit No. 11871
Group B2 Type Construction VN Fre Zone Use Zone CPS
Owner of Building Rick Morris Address P-0- Rnx 1 5 o S
Cit By Tom Hartung
Dote: March 12, 1993
Building Official
POST IM A C0N8PICU0U! PLACt
11
EXISTING
KITCHEN
4u Park Place
-51=230 'EisenhoDkve; ,1Y "Quiint;wj,' CA
CITY OF LA
PUNNING Ft � QUINTA
�«D� '1 Ef DEPARTMENT
91", siow
ccll .: LY
SUBJECT TOINSTALLATION AS PER
�Q�
AND ALL APPLICABLE CODES= .
nATE
BY
itio
try/Exit
ntry
Scale: 1/8' = V
® New Construction