10560 (MISC)llc&ty'l
Q9
P.O. BOX 1504. No. 10560
Building 78-105 CALLE ESTADO
Address 78-530 .,VIA SONATA LA QUINTA, CALIFORNIA 92253.
C r__
Owner
PAULEELIS
f,A�ilinn BUILDING: TYPE CONST. OCC: GRP.
Address SAME
City
•LA QUINTA
Contractor
OWBEd? BUILDER
Address
SAME
City
P. Number
Zip Tel.
92253 92263 Legal Description
Project Description 1501 X '61
Zip - I Tel.: ,
State Lia
ity
& Classif.
Pic.#
Sq. Ft.
No. No. Dw.
Size
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
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 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 o/ 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 appltcant 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, win'
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Suisness and -
Professions Code: The Contractor's License Law does not apply to an owner of property who,
Estimated Valuation
[ 3 75�
Y •
. PERMIT
_
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
Const.
'�' �
•
Mech.
I
builds or improves thereon and who does such work himself or through his own employees,
provided that' such. Improvements are not .intended or,oflered-for, sale. If, however, the' building
or improvement is sold within one year of completion, the owner -builder will have the burden
o/,proving that he did not build or improve for the purpose o/ sale.) '
Electrical-
Plumbing
b I, asowner of the property, am exclusively contracting with licensed contractors to con-
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. /or
-such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. i B: & P.C. for this reason'
S.M:I.
-
_ • 40
Grading
-
Driveway Enc.
,//Date�*~L� •Owner ' -+ \y%.-
i
Infrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's,Compensation Insurance, ora certified copy.thereof. (Sec. 3800,. Labor Code.)_
Policy No. .Company '
❑ Copy is filed with the city.. ❑ Certified copy is hereby furnished.
TOTAL
$63.40
CERTIFICATE OF EXEMPTION FROM '
WORKERS' COMPENSATION INSURANCE •
This section need not be comple.ed !/ the permit one hundred dollars ($100 valuation
( )`�•s)AE.-r•A"x*x
orless.)
I certify that in the performance of tha,wortC:for which this permit is issued, I shall not
employany pparson in any manner so as toabecor a subject to the Workers' Compensation
Laws,ofCalifornia. .� r , \
1,I�Date d Owner M- t 'e•. \c *-
NOTICE TO APPLICANT: If, after makirig'thfs CertificaTe of"Ex"emption you should become
subject to the° Workers' Compensation provisions o/ the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
REMARKS
�#€i'u
'
ZONE: BY:
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
Lender's Address
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.
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.
Signature of applicant— Date -
Mailing Address
City, State, Zip
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL, AREA
2ND FL. SQ. FT.
YARD SPKLR SYSTEM
POR. SQ. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. SQ. FT.
DUCT WORK
DRAINAGE PIPING
WALL SQ. FT.
DRINKING FOUNTAIN.
SO. FT. ®
HEATING (FINAL)
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property lax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
G-0
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
GRADING
cu. yd.
$ plus x$
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SO.FT.GAR ® 3/ic
HOUSE SEWER
SPARK ARRESTOR
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
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
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 �!
G-0
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
-$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
-
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION `l
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL