15086 (SFD)P.O. BOX 1504 No. 15086-
Building 78-495 CALLE TAMPICO.
Address -aQ5 ilia �.renze LA QUINTA, CALIFORNIA 92253
Owner
C�ntt3.t� .tics ..a�lmngii� es
Mailing
BUILDING: TYPE CONST. OCC: GRP. R_
Address 1535 'South "Do Street A.R. Number 617'-i9t` -005
City Zip Tel. Lot- :5 Tract 26152 Phase ; a -. .
San Bernardino, .CA 92408 (909) 381-6007 Legal Description
Contractor - SFA P1azl 4
S�Q . Project Description
Address Spinnaker Cove -at Lake La (uinta
IZip - - ITel.:
State Lic.City
& Classif..: a 314473 Lic. # 2120
Arch:, Engr.,
Designer Frank .tonzallet .& Associates
'isItts East Ch4prttan Ave. Tel (710 532-687
CityZip, State
Qranse, -Ch:,-- . 92666 Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that'l am licensed under 'p'r iov sions•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 s r =
SIGNATUREDATE
Co
,WNER-BUILDER DECLARATION
I hereby affirm that I•a exempt from the Contractor's License Law for the following
reason:. (Sec. 7031.5,13usiness,'and Professions Code: Any city or county which requires a
Permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit .to rile 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 penally 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
do the work, and the structure is not intended or offered for sale. (Sec. 7044, auisness 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 inprovements 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
or proving that he did not build or improve 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 and Professions Code: The Contractor's License Law -
does not apply to an owner of.property who buildsor improves thereon, and who contracts./or
such projects with contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Dale Owner
WORKERS' COMPENSATION DECLARATION
Ihereby 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. O Certified copy is hereby furnished. . .
Sq. Ft. 2457 No. No. Dw.
Size 'Stories - Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ i
mated Valuation ' $145t763.00
PERMIT
Plan Chk. Dep.
Plan Chk. Bal.
Const.. r
Mech. r
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
Arts in Ptabli
s
TOTAL
AMOUNT
r �
fJ
.00
3 3,279.67 rr��
r 2 T��gg9 e 6/
" CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need,not be completed ff the permit is for one hundred dollars ($100) valuation
,.,,•+P-�.
' or less.)
I certify that,in the performance of the work for which this permit is issued, I shall not
_
employ any pperson in any manner so as to become subject to the Workers" Compensation
Laws of California.
Date Owner
• NOTICE TO APPLICANT.- N, after making this Certificate of Exemption you 'should become
•
ZONE: BY: -
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. -
Minimum Setback Distances: ..
Front Setback from Center Line
Rear Setback from Rear Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND
Side Street Setback from Center Line •" -
SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
Side Setback from Property Line
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
This is a building permit when'properly filled out, signed and validated, and is subject to •:
FINAL DATE INSPECTOR
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.
Issued by: Date Permit
I agree to comply with all city and county ordinances'and state•laws relating to building
construction, and hereby authorize, representatives of„ttiis-,city to enter the/above-
he/above•.--
mentioned
mentionedpropertyforinspectionpurposes:�' ,e'.�-^�� /pI
�A
Validated by:
Signature of applicant . _ =^�f'/ ✓"'r�Date ,'rf` 1
Mailing Address -?°'� %. %�”" ) r.
Validation:
City, State, Zip a
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBINU FEES t
IST FL. SO. FT. ® $
UNITS
COLL. AREA
2N0 FL. SO. FT.
PLUMB.
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SD. FT.
DUCT WORK
DRAINAGE PIPING
WALL SO. FT.
GAS (ROUGH)
DRINKING FOUNTAIN
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
AS (FINAL) 3 G�
i
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
I WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
WATER SYSTEM
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRYTRAY
AIR HANDLING UNIT CFM
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID CED 11A c
SEWAGE DISPOSAL
SO.FT.GAR p 3/ic
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 j
GROUND PLUMBIN
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE or -ROUGH
PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
E E RI(
V
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
AS (FINAL) 3 G�
i
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FR ING Z/
FINAL INSP.
ROOFING 0 •
�y
&Z
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND��
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIONATURESIINITIALS
GARDEN WALL FINAL