06922 (SFD)C&t!t
4
P.O. BOX 1504 N o . 06922
Building
Address 78-515 Via Metadla LAQUINTA,CALIFORNIA 92253
Owner
9ARCON DEVELOPMENT BUILDING: TYPE CONST. OCC. GRP.-
Mailin
Address 68-713 Perez Road, #1 Tract #21555-4a Phase Iia
A.P. Number
City Cathedral Ci Zip 92234 ]T�F77_3-9024
Legal Description
Contractor PARC LR QUINTA
Project Description
Address Plait 2222 M Lot ,#22
City Zip Tel.:
ate Lic. City
�tCla sif. 337077 L'Ic. # 1.2192, 222
Sq. Ft No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ® Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Address Tel
City Zip State
'11 j Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm`that I am licensed;under provisions of Chapter 9 (commencing with Se tion
7000) of Divisio�n 3'of the'Business and ProfessionsCode,rand my license s,In,full fo(ce.and
7•r
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, Improve, demolish, or repair any structure, prior to its Issuance also
requires the applicant for such permit to Me a signed statement that he is licensed, pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or
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 Plan Chk. Dep. -
subjects the applicant to a ciw7 penally of not more than live hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 57
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 685.00Professions Code: The Contractor's License Law does not apply to an owner of property who
bolds or Lmproves thereon and who does such work himself or through his own employees, 60.00
Mech.
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 . Electrical 120.79
of proving that he did not build or Improve for the purpose of sale.) 10.50
�1A �n
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 10. 50
struct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law �.�
does not apply to an owner of property who Iulds or Inproves thereon, and who contracts for S.M.I.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date owner Infrastructure 2,523.63
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.
TOTAL 1 its 1 �' `r j
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE ne. aH-z r:ra
,}(rhis section need riot be completed ff the permit is for one hundred dollars (5100) valuation x•qr+!� yaa.T ^,;.7.5
or es)
$ n
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 ZONE: - - BY:
sutject to the Workers' Compensation provisions of the Labor Code, you must forthwith
Commplywith Such Provisions atthisPermit shall bedeemed revoked. Minimum Setback Distances:
Front Setback.from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION 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 FINAL DATE INSPECTOR
This is abuilding 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. 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 this city to enter the above-.
mentioned property for inspection purposes.Validated by:
Signature of applicant Date
Mailing address Validation:
City,. State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
"ol
ROUGH PLUMB. B NDI V u/4.10A r 7'3 d —
YARD SPKLR SYSTEM
2ND FL SO. FT.
FORMSlei
Al
57
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
FOUND. REINF.
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
OTHER APPJEOUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SO. FT. ®
WALL SO. FT.
DRINKING FOUNTAIN.
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER SYSTEM
WATER PIPING
NOTE: Not to be used as property tax valuation
LUMBER GR.
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
VENTILATION
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER. B.T.U.
SO. FT. ® c
BATH TUB
LATHING 3d
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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
GROUND PLUMBING �I DERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
"ol
ROUGH PLUMB. B NDI V u/4.10A r 7'3 d —
HEATING (ROUGH)
STORAGE TANK
FORMSlei
Al
57
SEWER OR SEPTIC TANK l ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH) METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ —Plus—x$—=$
LUMBER GR.
FINAL INSP. �/ d
l
FRAMING 3
FINAL INSP.
ROOFINGd
�VV ♦
� vt�Jls
I (/
�1 %
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING 3d
MESH
INSULATIONISOUND2INQ p
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL