09381 (SFD)...p•+ _ "4
P.O. BOX 1504 , ? No'' . 09 3-8 ~
Building i 78-105 CALLE ESTADO ..
Address A7-410 -410 Via. Ki3ron.• LA QUINTA, CALIFORNIA 92253
Owner
1i TT'R? 'PA 1PTf1-. 7i V BUILDING: TYPE CONST. OCC: GRP. -
Mailing ,
Address oi
. 3 .fie Street A.P. Number +-
City - Zip Tel._ ,
Legal Description ?��t�e ra'az: st71 �r T.akp T-ra mint •, rk 110 n '
Newno t pe c 92660 .#14/,851-:14 3 - .
Contractor
Project Description ,coil -, 1.95 Pla-A
Address
City Zip Tel.:
State Llc. • City
& Classlf.' Lic. # Sq. Ft. No.' No. Dw. _ {
X537$7 1730 " Size 310 ' :Stories Units
Arch Engri, -
DesignerNew ❑ Add ❑, Alter ❑ Repair ❑ Demolition -0
-a McCallum
Address Tel360-02W
apyyppe` 0/yampw{
City s Zip State-
Lic. #
C7424
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm -that I am licensed und'erprovisions of Chapter (commencing with Section
7000) of Dlasion 3 of the Business at d&Professions Code, and my license Is in full foice and ;
•effect
ti .;fir `�-%' ZI
SIGNATURE + �"' o.. :1+"• iF I' ,rF .i >;l` �d'4.-i•^cw�r. ,I '!' DATE ... .. .. .
p�>fOWNEWBUILDERDECLARATION; r
Iz hereby affirm that`I am exempt from the Contractor's License Law for the following Estimated Valuation' ";
reason: (Sec. '•7031.5, Business and Professions Code: Any city or county which •requkes a •' 7r. -irl Irk
•' :permit
to construct, alter, improve, demolish, or repair any. structure,. prior to its issuance also
T.requires the applicant for such permit'to -file a signed statement that he Js licensed pursuant to .PERMIT. , • . . AMOUNT,
the provisions of the Contractor's License Law, Chapter 9 (commencing :with Section 7000) of h
Division 3 o/ 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 permitPlan Chk.'Dep. _
subjects the applicant to a civil'penalty of not more than, live hundred dollars ($500).
❑ I, as owner of'the property, or. my employees with wages as their sole compensation, will I. Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and J y r
.: Professions Code:, The Contractor's. License Law does'not apply to, an owner .of property: who Const.
builds or improves thereon and who does such 'work himself or through his..own employees, ;Meth. - - '
provided that' such improvements. are not 'intended .or offered for sale. IF, however, the: building i n'q -nn
n
An
or improvement is sold within one year of completion, the owner -builder will have the burden . t r '
of proving that he did not build or improve for the purpose of sale.) Electrical, e,
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ^.•
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.) - -
Grading
O Lam exempt -under Sec. B. & P.C. for this reason '
` Driveway Enc.
Dateowner ' Infrastructure
.-WORKERS' COMPENSATION DECLARATION,—
'I hereby affirm that'l'ha4e 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
O Copy is filed with the city. . .0 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.) - - '
A certify that in the performance of thp.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.
subjeot to the Woikers' Compensation provisions o/ the- Labor Code, you must forthwith
- comply with such provisions or this permit shall be deemed revoked.,
CONSTRUCTION LENDING AGENCY.
1 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 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.
Signature of applicant— Date
Mailing Address
City, State, Zip
ignr?-f"°YtX ` J11f �L•+s^Y _;. ,� .�..'
TOTAL :, 7716-21,
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:
,.. • 1. t�{'S ; •iY'K• a ♦'.0 j; _'i � ..3:..J .r J.,l <- t. r .r., ! ..
ii +au - 'd• •.�•i^.ar ' °"!•<<. ,3�'r iT. i�-•.Ai _. .•>�e ,. ..� Sy I � � .-i.
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
ROUGH PLUMB. BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
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.
SQ. FT. ®c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
BOND BEAM
SQ.FT.GAR ® 3/4c
HOUSE SEWER
WATER SYSTEM
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 -111011,q
G/)
GROUND PLUMBING �l 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) it / METER LOOP
!l C
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL71
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
0 cu. yd.
$ -Plus-X$-=$
LUMBER GR.
FINAL INSP.
Q , It
FRAMING l l L V
FINAL INSP. / L
ROOFING
� �
L/ i -v ry Ul
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HIN
MESH
INSULATION/SOUND t
FINISH GRADING
FINAL INSPECTION L
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL