09384 (SFD)�j
Building
Address 47-350 Via
Owner
,l
Tit*
P.O. BOX 1504
78-105 CALLE ESTADO .
7011 LA QUINTA, CALIFORNIA 92253
Mailing
Address 1301 Dove Street
City Zip Tel.
Newport Beach 92'56£3 14/851-4411
Contractor
ress
Zip
State Lic. City
& Classif. 453787 Lic. # 1734
Arch.; Engr.,
Designer ' Walling & McCallum Lt.
Address Tel. ,
•364'•0230
City Zip State
Lic. # C7424
LICENSED CONTRACTOR'S DECLARATION
I hereby atfirmjthat I am licensed under provisions of Chapter 9 (commencing with Section -
.7000) of Diyis on 3 of the Business.arib'Professlons Code, and my license is iwfull force and
effe t. . O/7, 1, ..'(1.•'h1n. 4' A A-1 }T
SIGNATURE---If`�"'""" '"�f.� ILp / �•" e" SI If f DMTE
fI OWNER -BUILDER DECLARATION
I hereby affirm tha,1 am exempt from the Contractor's License Law for the following
_..reason:. (Sec. 70.3 1.5, Business and Professions Code: Any city or county which requires a
penrmitJo 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
sr• -'.Division 3 of the Business and Professions Code, or that. he Is exempt therefrom, and the basis
/or 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).
0 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, Bufsness 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 emplcyees,
provided that such improvements are not intended or offered.. for sale. It, 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 or 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 builds or improves thereon, and who contracts for
- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner
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. O 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) va!uation
or less.)
I certify that in the performance of the work for which this permit is issued, I shell 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 youshould 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 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 cityand 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
No. 09394
BUILDING: TYPE CONST. OCC: GRP. -
A.P. Number
Legal Description or, Laka La Quignta
Project Description . Lot 197 ' plait 2 4_1 1
Sq. Ft. No. No. Dw.
Size 2924 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition-❑
Estimated Valuation
7 _Aa
PERMIT AMOUNT
t
Plan Chk. Dep.
Plan Chk. Bal. r a
Const.
Mech.. _ nn
Electrical yel, A An
Plumbing �0
S.M.1. in
Grading Y�
Driveway Enc.
Infrastructure :Q 0A
TOTAL
REMARKS
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 by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. FT.
WALL SQ. FT.
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS- 7 4•
MOBILEHOME SVC.
POWER OUTLET
`'
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
ROUGH PLUMB.
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GAS (ROUGH) n I
A
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
'
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID a 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP. Z { /
ROOFING � (: ll�G2 � L �
1
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 �/GROUND
PLUMBING 419qc
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) n I
A
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
'
WATER SYSTEM
GRADING
ecu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. 2 /
•
FRAMING Z� l (� L6J
FINAL INSP. Z { /
ROOFING � (: ll�G2 � L �
1
^/ /
T(� (O(
� f
'•/
REMARKS:
VENTILATION .
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR.. FIREWALL
HING
MESH
INSULATIONISOUND'?'� l Cp
l
FINISH GRADING
FINAL INSPECTION)Ala
° CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
I
7
0,
4
J,
61.� #H b
This: Certificate issued,,gursuant• to the requirements of Section;306 of the Uniform Building
'z:'66de 'certifying that at'the time of issuance this structure, wasJnP
- ebm Hance with the various
-
ordinances of the Cit BUILDING ADDRESS Yregulating buildiq.9 construction -or use.- ,F the following:
-
47-350 Via-,Koron
-'09384
Use Classification SFD Old9Permit No.
Group R3 Type Construction VN Fire Zone..:— Use Zone Rl-
Owner, of'Buildi ng Wilma Pacific, Inc., Address 1301- Dove 'Street
..City w.' Newport Beach, CA 92660
Byl Lonn3,p, "Day
Dots; 10 29/91.
CA14
POST IN A CONSPICUOUS PLACE