003564 (BLCK)P.O. BOX 1504 No. 003564
Building 78-105 CALLE ESTADO
Address 54"295 Eisenhower LA QUINTA, CALIFORNIA 92253
Owner
Anthony Sestich :$2$ Const. BUILDING: TYPE CONST. • OCC: GRP.
Mailing
Address P. C« BOX 837 A.P. Number ` 174-252-6-15-. 1 `?
City Zip Tel.
LA . 92253 564_iOfil Legal Description
Contractor. Project Description 401 X� fie ninth Block gall
A nthonv Sestich AMS Const.
Address ..
Same
City Zip Tela
State Lic. City
& Classif.. 535932 Lic. # 1047 Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I herebyffi
arm that I em licensed under provisions of Chapter 9 (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 Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License 'Law for the following (�1 a�
reason: (Sec. 7031.5,Business and Professions Code: Any city or county. which requires a
permit to construct, alter, improve, demolish, or Professions.
a$dny structure, prior to its issuance also - -
requires the applicant for such permit to file a signed statement that he isolicensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of •rI
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 Plan .Chk. Dep. - -
subjects the applicant to a civil penalty of not more than five hundred dollars, ($500).
O I, as owner of. the. property, or my employees with wages as their sole compensation, will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. '
Professions Code: The Contractor's License Law does. not apply to ,an owner of property who o,)ia n;A
builds or improves thereon and who does such work himself or through his own employees, Mech. -
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 Electrical
of proving that he did not build or improve for the purpose of sale.) .
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
str.1 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 S•M:I:
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ 1 am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date ' Owner Infrastructure
WORKERS' COMPENSATION DECLARATION
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.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
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 thq work for which this permit is issued, I shall not nt;'W'; r ; i?Ti'?1. 1`•ie �; ?..IcS3 4 (i
employ any person in any manner so as to become subject to the Workers' Compensation�, t
Laws of California. (?J I t it, I 4 l, .
Date "• Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: - 'BY:
Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: -
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
j 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.) Side Setback from Property Line
Lender's Name
Lender's Address FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated; and is subject to
expiration it work thereunder is suspended for 180 days.. j
I certify that I have read this application and state that the above information is correct. Issued by: Date ermit
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. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
>b• HARD COPY
T '
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
UNDERGROUND
A.C. UNIT
1
1ST FL. SQ. FT. ® $
UNITS
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH.)
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
REINF. STEEL I
g
DRAINAGE PIPING
CAR P. SO. FT.
WALL SQ. FT. ®
DRINKING FOUNTAIN
SO. FT. @
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
GRADING
cu. yd.
$ plus x$
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, 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.
SO. FT. RESID ® 1'/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
I 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.IEQUIP.
REINF. STEEL I
g
/ (FI L)
TEMP. POLE
GROUT
WA�14 HEATER
SERVICE
FINAL INSP.
OND BEAM /� G _
v
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