07265 (SFD)P.O. BOX 1504 No. 0726.5
Building 78-105 CALLE ESTADO
Address 78-340 Via Sevilla LA QUINTA, CALIFORNIA 92253
Beane Homes
BUILDING: TYPE CONST. OCC: GRP. -
A.P. Number 623-402-004 a 009, 010
Le Telt. Tr. No. 23371
gal Description
Project Description Phase I. - A
Lot Ib
Mailing
Address 15 Agusta
City
Ratiehv 141 1"
lZip
3e 32270
Tel.
Contractor
Address
city,
Zip
Tel.:
Side Street Setback from Center Line
1 hereby affirm that there is a construction lending agency for. the performance of the
State Lic.
& Classif. 50320
City
Lic. #
Sq. Ft. 33610
Size
No. 2 No. Dw.
Stories Units
Arch., Engr.,
Designer
New ❑ Add ❑
Alter ❑ Repair ❑ Demolition ❑.
Address
Tel.
FINAL DATE
INSPECTOR
INSPECTOR
City
Zip
State
Lic. #
expiration if work thereunder is suspended for 180 days: .
f
I car ity that I have read this application and state that the above information is correct.
'
LICENSED CONTRACTOR'S DECLARATION
1 herebWaffirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of O"visilon�3`of�the Busin Piofessio�h�stCode. and my license is n f Ilff�rceyand
effect. kr,yA � �*�^ � ""6 `/ )
Date Permit
I agree to comply with all city and county ordinances and state laws relating to building
'
SIGNATURE DATE
OWNER -BUILDER DECLARATION'
I herebyaffirm that I am exempt from the Contractors License law for the following
reason: (Sec. 7031.5,13usiness and Professions Code: Any city or county which requires a
permit to construct, after, improve, demoLsh, or repair any structure, prior to its issuance also
requires the applicant for such permit to We a signed statement that he is licensed pursuant to
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
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ 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, Buisness 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 employees,
provided that such improvements are not intended or offered for sale. H, however, the building
• or fmprovement is sold within one year of completion, the owner -budder will have the burden
of proving that he did not build or improve for the purpose of sale.)
0'1, as owner of the property, am exclusively contracting with licensed contractors toxon-
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.)
• ❑ I am exempt under Sec. a; 8 P.C. for this reason
Estimated Valuation
��+e2g
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
$4,82159
Const.
Mech.
U1150+
Electrical
_
1�,% 62
Plumbing
!
S.M.I.
12.04
Grading
Driveway Enc.
Date owner
Infrastructure
s3.
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.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
"
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE"t
' (This section need not be completed H the permit is for one hundred dollars ($100) valuation
or less.)
1 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
— — A
TOTAL
REMARKS
mac_ - r+y�r'^ A r}
4+f`e `i 4 '. i ..� v
Date Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
ZONE:
BY:
subject to the Workers' Compensation provisamis of Me Labor 'Code, you must forthwith
comply with such provisions ofthis Permit shall bedeemed rewked.
-
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
1 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
FINAL DATE
INSPECTOR
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subjecrto
8
expiration if work thereunder is suspended for 180 days: .
f
I car ity 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
IST FL. SQ. FT. @ $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. SQ. FT. @
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
DUCT WORK
ROCK STORAGE
OUND. REINF. —
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. @
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
DRAINAGE PIPING
CAR P. SQ. FT. @
WALL SQ. FT.
DRINKING FOUNTAIN.
FINAL INSP.
URINAL
SQ FT @
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
—cu. yd.
$ —plus—x$_=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP. D
FLOOR DRAIN
MECHANICAL FEES
ROOFING vOL(, j
t
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
IKITCHEN 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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 1% c
SEWAGE DISPOSAL
SO.FT.GAR @ 114c
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PL.CK.FEE
TNST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
OUND PLLIMBINd5/fV 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
OUND. REINF. —
_
GAS (ROUGH) Q 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. D
FRAMING �� fi�
FINAL INSP. %/
ROOFING vOL(, j
t
l
' fla1�6 L r
_ n �4AP
)/"C ( 9 ! l V
Pre
REMARKS:
VENTILATION
FIRE ZONE ROOFING '
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA ING O Z17 /—h
MESH
INSULATIONISOUND m co
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL