06912 (SFD)r P.O.-BOX 1504 No. 0.6912
Building%iS'-520 f � 7&105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253 .
Owner
ARGON DEVELOP14ENT
Mailing
Address 68-713 Perez Road% 01
CityCathedral Citylzip 92234
cAx.irl 1'
Contractor °
Address
. City . Zip
State Lic. lI /. I City
& Classif. Lic. #
Arch., Engr.,
Designer
Address Tel.
City Zip State
7 " Lic. #
! LICENSED. CONTRACTOR'S DECLARATION
I hereby affirm that I am•licensed under provisions of Chapter 9 (co
7000) of Division 3.ofAt a Business and Professions Code, and my,lic
M
OWNER-BUILDER DECLARATION'
hereby affirin that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct. after, improve, demofsh, or repair any structure, prior to its issuance also
requires, the applicant for such permit to file 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 &rsoress 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 cwt penafty 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 appy *to an owner of property who
builds or improves thereon and who does such work himself or through his own employees,
provided that such inprovements are nor intended or offered for sale. If, however, the building
or improvement is sok/ 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.)
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project (Sec. 7044, Bushhess and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or hnproves thereon, and who contracts for
such projectswitha contractors) dcensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec_ a• g P.C. for this reason
Date Owner
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed f1 the permit is for one hundred dollars ($100) valuation
or less.) '
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any penton in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date - Owner
NOTICE TO APPLICANT: fl, after makirW Oris Certificate o/ Exemption you should become
subject to the Workers' ConpensaOm provisions of the Labor Code, you must . /orthwith
comply with such provafons or this permit shat be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of. the
work for which this permit is issued. (Sec. 3097, C" Code.)
Lenders Name
Lender's Address
This is abuilding permit when property filled out, signed and validated; and is subject to
expiration if work thereunder is suspended for 180 days.
1 certify that I have read this application and state that the above information is correct.
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
BUILDING: TYPE CONST. OCC: RP.
Ira cy ts55 � Rase IV
A.P. Number
Legal Description
11111L LA 4&14411A,
Project Description _
Description,,,,
ZZZ tit :. Lot V.t
Z zzi .
Sq. Ft. No. No. Dw.
Size Stories Units
New big Add ❑ Alter ❑ Repair ❑ -Demolition ❑
Estimated Valuation $122,161
PERMIT AMOUNT
Plan Chk. Dep.
Plan Chk. Bal. six,
Const_ 065. at-,
Mech.
igaf. uu
Electrical
127U.,79
Plumbing -
144. bu
S.M.I.
Grading
Driveway Enc. ? .
Infrastructure
t� S•t13
Ie
TOTAL
—V;"2793
s, 3
REMARKS
1.ti ti±&as= Y id3io. 5 Y.4�s t. r u
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:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS
SEWER OR SEPTIC TAN &TOUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH) [l[[ (, 1 o METER LOOP
ll
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
GAS (FIN/u,y (/ TEMP. POLE
(
GROUT
DRAINAGE PIPING
CAR P. SQ. FT. ®
FINAL INSP.
BOND BEAM
DRINKING FOUNTAIN.
WALL SQ. FT.
_$
LUMBER GR.
FINAL INSP. 1�40
FRAMING vq/cfa(,--
URINAL
SQFT ®
F
�c% �i.� �J�
(/ `Z C
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, TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
FINISH GRADING
SQ. 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 2 C_UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TAN &TOUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) [l[[ (, 1 o METER LOOP
ll
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FIN/u,y (/ TEMP. POLE
(
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. 1�40
FRAMING vq/cfa(,--
FINAL INSP. `/�
ROOFING /2&
C
F
�c% �i.� �J�
(/ `Z C
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LAING B
MESH
INSULATIONISOUND �2 D
FINISH GRADING
FINAL INSPECTION _`l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
'
GARDEN WALL FINAL:d
I