09234 (PAT)414
P.O. BOX,1504„•'C -:r —..r NO. 0923.
Building 78-105 CALLE ESTADO
Address 78-375 Via Sevilla LA QUINTA, CALIFORNIA 92253
Owner
'Mailing BUILDING TYPE CONST. OCC: GRP.
� �.
Addressi
A.P: Number
City Zip Tel.
` 221-5.. 3 60 19_°42 Legal Description
Contractor Project Description
1?'iL:78S Ci Pe 1( 'aJY
Address.:. t n Onve
City Zip Tel."
State Lic." City
& Classif..' Lic. # Sq. Ft. No: No. Dw.
Size 294 Stories Units
Arch., Engr.,
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
,• _SIGNATURE DATE _
OWNER -BUILDER DECLARATION
'1¢f,he'reby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation
n,,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 AMOUNT
:.,requires the applicant for such permit to lile.a signed statement that he is licensed pursuant to PERMIT -
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..
ubf is 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. Plan Chk. Bal. 40'.95
do'the work, and the structure.is not intended or offered for sale. (Sec. 7044, Buisness and Const. }j
Professions. Code: The .Contractor's License Law does not apply to an owner of property who- s .
builds or improves thereon and who does such work himself or through .his own employees, Mach.
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
of proving that he did not build or improve for the purpose of sale.)
❑ 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 propertywhobuilds or improves thereon, and who contracts -for . S.M.I. .."70
such projects with a contractor(s) licensed pursuant to,the Contractor's License Law.)
Grading
0 1 am exempt under Sec:. B. & P.C. for this reason
Driveway Enc.
Date Owner? ` t AK - Infrastructure
WORKERS' COMPENSATION DECLARATION .
I hereby affirm that 1 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 104.23
23
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation �' 6gt, � i S�.` �}. ,r"3„ . ,14
or less.) -
I certify that in the performance of thg work for -which this permit is issued, l 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, a er making this Certificate o/ Exemption you should. become .ZONE: BY:
subject to the Workers' mpensation this
of the Labor Code, you must forthwith . Minimum Setback Distances:
comply with such provisions or this permit shall be, deemed revoked. -
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
Lender's Address FINAL DATE INSPECTOR
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. 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
Y.. u
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES,,
1ST FL. SQ. FT. ® $
+ UNITS
SETBACK G
2ND FL. SQ. FT.
UNDERGROUND
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SQ. FT, ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
SEWER OR SEPTIC TANK
DRAINAGE PIPING
WALL SQ. FT.
ROCK STORAGE
DRINKING FOUNTAIN.
SO. FT. ®
METER LOOP
URINAL,
ESTIMATED CONSTRUCTION VALUATION $
REINF. STEEL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LUMBER GR.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FRAMING .3 —
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
FIRE ZONE ROOFING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SPARK ARRESTOR
SQ.FT.GAR ® 3/ac
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 G
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE IV
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSly
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
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 .3 —
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING I•—/(—BL(
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION �/
l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL