002860 (3&4)Building 345
Address 55r
mailing
Address '75--90.5 O=atXy Club DriVe
City Zip Tel.
Palm,DeWft 92260
Contractor
tiom . M=tmstm and Lm
Address
P.O. BOX 1504 N o .
78-105 CALLE ESTADO 002860
LA QUINTA, CALIFORNIA 92253
568-2828
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description
Project Description TIM IMM—T PMS'. I -A R
p ark SO M
City
Sam
Zip
Tel.
State Cic.
& Classif. .
28
-Size
City
Lic. #
2
3142
Sq. Ft.
GM 589.
No. No. Dw.
Stories Units
Arch., Engr., - '
Designer
New 0 Add ❑
Alter ❑' Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #'
_ LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that.l am licensed under provisions of Chapter 9 (commencing with Section
j 7000) t. of Division 3 of the Business and Professions Code, and my license is'in full force and '
_t
-
SIGNATURE r r.•tl- - J*: •' ,<'- - DATE
vOWNER•BUILDERDECLARATION
I hereby affirm that I am exempt from the Contractor's. License Law for the following
Estimated Valuation
215,834.00
reason: (Sec. 7031.5,Business and Professions Code: Any.city or county which requires a
PERMIT
AMOUNT
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 dkempt 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). ' -
O I, as owner of the property, or my employees with wages as their sole compensation, will
.Plan Chk. Dep.'.
- ..
-
Plan. Chk. Bal..
593.44
Const.
- 'MAD
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
Mech.
�
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
Electrical
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving Mat he did not build or improve for the purpose of sale.)
Plumbing
140_50
❑ I, as owner of the property, am exclusively contract Ing.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
S.M.I.
.,
•' - , � (�
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason
Grading
Driveway Enc.
&
Date owner
Infrastructure
2.000.00
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 certified copy thereof. (Sec. 3800, Labor Code.)•
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.'
TOTALn�
REMARKS
' 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 the 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.
ZONE:. BY: '
.Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
colvsraucrloN LENDING AGENCY
-
Side Street Setback from Center Line
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
Lenders Address
This is a building permit when properly filled out, signed and validated, anclAs 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. J ,
Signature of applicant 1 + f •i 7 Date f '
FINAL DATE
Issued by:
Validated by:
INSPECTOR
Date 1-27—A7 Permit
Mailing Address `- • `'"
Validation:
A7206
'
1 3U 5655,68 Ch
' City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL F
NO. PLUMBING FEES
1ST FL. SQ. FT. ®
UNITS
MWISLABGRADE 2 -' _
UGH PLUMB 6
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
WER OR SEPJIC Nf-)
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
HEATING (FINAL)
OTHER APP./EQUIP.
DRAINAGE PIPING
CAR P. I SQ. FT. ®
TEMP. POLE
WALL SO. FT. ®
GROUT
DRINKING FOUNTAIN
SO FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
_$
FLOOR DRAIN
MECHANICAL FEES
r406RAMING /1�..�
•
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
FIRE ZONE ROOFING
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
THING 14�"'
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T,U.
SQ. FT. RESID ® 11/. c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINISH GRADING
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
ffwETBACK �
OUND PLUMBI /(/-
UNDERGROUND
A.C. UNIT
COLL. AREA
MWISLABGRADE 2 -' _
UGH PLUMB 6
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
WER OR SEPJIC Nf-)
jfgfr0UGH WIRINCi'1/0_'�,1 �
/
DUCT WORK
ROCK STORAGE
O�UND. REINF. 3
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
INF. STEEL 2
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
G
INAL INSP. �"p
r406RAMING /1�..�
•
INAL INSP. �- /—Q'7
d-411OOFING(� ��
®I i 6 le- rQ w /(ter r
/^
/ 4 / CCi AAA ' l
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING 14�"'
MESH
&NSULATIONISOUN06�'-1 V — / p - I7
FINISH GRADING
INAL INSPECTION 210,/
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL