05932 (SFD)•4.4 a
�J
P.O. BOX 1504 No. 05932
Building 78-105 CALLE ESTADO
Address 78—VO Via Melodia LA QUINTA, CALIFORNIA 92253
Owner +�
Mailing
$8rcog Dev. . BUILDING: TYPE CONST. OCC: GRP.-
,
Address 6a-713 Perez Rd. # 1 A.P. Number
City Zip Tel.
Cat City $2234 773--4024 Legal Description tease aY 14t 12
Contractor. Project Description Plan 1.8-04 Parc La Outate
same
Address r.
City Zip Tel.:
State Lic.City
& Classif., ` 337077 Lic. # 1219„ Sq. Ft. 1804 No. No. Dw.
-Arch., Engr.,
Size Stories Units
,Designer New)M Add ❑ Alter ❑ Repair ❑ Demolition ❑
• Address Tel.
City Zip State
r • , Lic. #
LIC84SED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
effect.
Division 3 of the siness and Professions Code, and my license is in full force and
effect �^ �! �-✓Ul 1, SOLA P"I
SIGNATURE
DATE, -
OWNER -BUILDER DECLARATIONEstimated Valuation
I hereby affirm that 1 am exempt from the Contractors License law for the following.. 93,604.00
reason: (Sec. 7031.5,Basi ess and Professions Code: Any city or county which requires a:'
Permit to construct, .ager. Improve, demolish, or repair any structure, prior to its issuance also
requires the appftW 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). 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 Plan Chk. Dep.
subjects the applicant to a crvi penalty of rpt more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 512.33
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 612, 50
Professions Code: The Contractors 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. Mech. 52
provided that such improvements are not intended or offered for sale. If, however, the building.
.or improvement is sold within one year of completion, Ne owner -builder will have the burden Electrical ii
of proving that he did not bum or improve for the purpose of safe.) •-
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 138*50
struct the project (Sec- 7044, Business and Professions Code: The Contractor's License Law
does not appy to an owner of property who builds or inproves (hereon, and who contracts for S.M.1. •5�
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 b.L
WORKERS' COMPENSATION DECLARATION .�
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance; or a certified copy thereof. (Sec. 3800, Labor Code.) < N
Policy No ' xompany
❑ Copy is filed with the city- ❑ Certified copy.is hereby furnished.
TOTAL i ' 3 3 s� �% i ' !C`+ a i.;Lp
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE \ . REMARKS
(This section need not be eoopteted if the, permit is for one hundred dollars ($100) valuation .,�5. f '004rrt&.f 1,M0!)kp 1/4QIDu5.L'S x16
or less.)
I certify that in the performance of thg 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: C 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 orhyspermit shaffbedeemed 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, CM Code.) Side Setback from Property Line
Lenders Name
Lenders Address
This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. 6pI5Y6
I certify that I have read this application and state that the above information is correct. Issued by: Datey 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 SQ. FT. ® $
UNITS
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
YARD SPKLR SYSTEM
2ND FL SQ. FT.
DUCT WORK
ROCK STORAGE
Ot
y- /J
FOUND. REINF. ' �s}��//
v[ 4
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
REINF. STEEL
GAS (FINAL)–, TEMP. POLE
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
WATER HEATER SERVICE
FINAL INSP.
DRAINAGE PIPING
CAR P. SQ. FT.
WATER SYSTEM
GRADING
Cu. yd.
$ plus x$
WALL SQ. FT.
LUMBER GR.
DRINKING FOUNTAIN.
SQ FT ®
FINAL INSP.
URINAL
ESTIMATED CONSTRUCTION VALUATION $
REMARKS:
WATER PIPING
NOTE Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAR. FIREWALL
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.
SO. FT. ® c
BATH TUB
FINISH GRADING I
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.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 – UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE -712,e
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
Ot
y- /J
FOUND. REINF. ' �s}��//
v[ 4
GAS (ROUGH) �— _ METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
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. _
FRAMING
FINAL INSP.
ROOFING �! ESC O
G
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING Y<Y
MESH
INSULATIONISOUND
FINISH GRADING I
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
'
GARDEN WALL FINAL
1