09390 (SFD)Building
Address 47-325 Via Koran
Owner
Mailing '
Address 1301 Move 8txeet
City I Zip
Contractor
Address
Zip
State Lic.
& Classif. 45371
Arch., Engr.,
Designer Wall .A
f44 Q9WA;l
P.O. BOX 1504 140. 09390
78.105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
BUILDING:- TYPE CONST. OCC: GRP.
A.P. Number
Tet
7,14/851-14 11 Legal DescriptionMeflsa nn Lake_ La fuirita
Project Description Lot 192 Plan 1
TO:
City
Lic. # 1734 Sq. Ft3100 No. No. Dw.
Size . Stories Units
Address Tel.
364-4254
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
City
Zip
State
Distances:
Front Setback from Center Line
Lic-11 C7424
Rear Setback fron Rear Prop. Line
LICENSED CONTRACTOR'S DECLARATION
Side Street Setback from Center Line
I hereby affirm that I am licensed under�rovisions of Chapter 9 (commencing with Section
7000j•of„,Viv sio�np 3soJ�f,� a Business -Professions Code, and my license is in full force and
effect. 3! t f::6' s� ,fd t f�.d,. � � •
Side Setback.fron. Property Line
SIGNATUREF`�"�" f !A` v 1'""- '+ " '". DATE
'
))��rr OWNER -BUILDER DECLARATION
' I hereby affir•h'at I am exempt from the Contractor's License Law for the following
;reason: (Sec. 70 1.5,Business and Professions Code: Any city or county which requires a
�_;pgrmft to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
,4,;i.regufres the applicant for such permit to file a signed statement that he is licensed pursuant to
t;, 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.
Estimated Valuation
PERMIT -
-
Plan Chk. Dep.
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
Plan Chk. Bal.
Const.
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 .
;. or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he didnot build or improve for the purpose of sale.)
Electrical
Plumbing
❑ 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
S.M.I.
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
Grading
Driveway Enc.
Date Owner
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.
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: 11, 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
Ihereby 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 it 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 slate 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
Infrastructure
TOTAL
AMOUNT
1084.4.®
149.00
219.na
2101. X50
3J.99
5104.69
.317.19
14 4
REMARKS
ZONE:
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Rear Setback fron Rear Prop. Line
Side Street Setback from Center Line
Side Setback.fron. Property Line
FINAL DATE
INSPECTOR
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE .
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS'
SLAB GRADE l
2ND FL. SQ. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT. ®
GAS (ROUGH) I( 9 jt
I
DRAINAGE PIPING
WALL SQ. FT.
OTHER APPJEQUIP.
DRINKING FOUNTAIN.
SQ. FT. ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
"'
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FRAMING l( q
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
/� s -1A ((/'1 /
Jo� _ ^ 1
( GJY �YJ/
LAUNDRYTRAY
AIR HANDLING UNIT CFM
REMARKS:
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 ® 11/4 c
SEWAGE DISPOSAL
LU N
LkTHING AC1q 1 Cv
SQ.FT.GAR ® 3/ac
HOUSE SEWER
MESH
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
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 Y�
�UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE l
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) I( 9 jt
I
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
/ecu. yd.
$i plus x$
c$
LUMBER GR.
FINAL INSP. D�Z
FRAMING l( q
FINAL INSP.g-2,2 2
ROOFING S-�q �//1 Lb
VENTILATION
/� s -1A ((/'1 /
Jo� _ ^ 1
( GJY �YJ/
C ^
i-+
REMARKS:
FIRE ZONE ROOFING -
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL10
LU N
LkTHING AC1q 1 Cv
MESH
INSULATION/SOUND &t (L/,/q c
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL