12678 (PAT)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 78-655 aria Sonate. LA QUINTA, CALIFORNIA 92253
Owner
Greg Lanier
BUILDING: TYPE CONST.
No.
OCC: GRP.
12676
Address Same
A.P. Number
Legal Description
Project Description
Patio- cover
City
La Qui.nta, CA
Zip
12253
Tel.
564-5505
Contractor
Alft: BOX 977
'City
IA Quinta,
Zip
92253
77�-»24
Side Street Setback from Center Line
--
Iel40
State Lia
& Classif. B 61968€
City
Lic. # 2231
Sq. Ft. 6(jo
Size
r
No: No. Dw.
Stories' Units
Arch., Engr., -
Designer
New ❑ Add ❑
Alter.❑ Repair ❑ Demolition ❑
Address
Tel.
City
t"
Zip
State
Lic. #
Issued by:
LICENSED CONTRACTOR'S DECLARATION
I hereby affl�m'that I am licensed undeiIprovisions of Chapter 9 (commencing with Section
K000) of Mis"iig�o�`n 3 of the Business and Professions Code, and my license is in full force and
ffect.
Permit
DATE
OWNER -BUILDER DECLARATION
I 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) or
Division 3 or the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exemption. Any violation or 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. If, however, the building
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose or sale.)
❑ 1, as owner 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 for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec. B. & P.C. for this reason
Estimated Valuation
$7,980.00
PERMIT
AMOUNT
Plan Chk. Dep.
Validated by:
Plan Chk. Bal.
64.35 3
Const.
7� �>�.
•
Mech.
Electrical
Plumbing
S. M. 1.
x.80
Grading
Driveway Enc.
Date Owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
I herebyffltm that I have a certificate of consent to self -insure, or a certificate of
Worker's CO pensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy NCompany
Dopy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
1.64 15
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thq 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: If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall 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, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it 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 sof this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
REMARKS V
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
".a;µ'
INSPL�-'!
Issued by:
Dae
Permit
i
JAN 1 2 1994
JJ
Validated by:
*� r t
Validation:
+y
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES,
1ST FL. SO. FT. ® $
UNITS
r�
~
BONDING
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
FORMS l
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. p
TEMP. POLE
GROUT
DRAINAGE PIPING
CAR P. I SQ. FT. ®
FINAL INSP.
WALL SQ. FT. p
WATER SYSTEM
DRINKING FOUNTAIN
GRADING
cu. yd.
$ plus x$
=$
URINAL
SQ. FT. ®
FINAL INSP.
FRAMING
ESTIMATED CONSTRUCTION VALUATION $
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
FIRE ZONE ROOFING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
LAUNDRYTRAY
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.
SO. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSPECTION 11 CERT. OCC.
OCC.
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 rAv
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS l
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION 11 CERT. OCC.
OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
C =yTY OF LA ' U I NTA '
Contractor ress �A'°L LAUIt1T�
+� owner Job Address 7 ► A SOK T, k
This form shall be posted on the job with the Building Inspection Card at all times. in a
conspicuous place. It is the responsibility of the General Contractor or the Owner/Builder
to monitor the sub -contractors that are on this list are the same persons performing the
work.' Any changes of this list must be. approved by the City of La Quinta Department of.
Building and Safety prior to work being performed by a changed sub_contractor.. Failure to
comply will result in a stoppage of work and/or the voidance of building permit.
• �vurst
TRADE
SUB -CONTRACTOR -NAME
CONTRACTOR'S
LICENSE NO.
WORKMAN COMP.
NO. ON FILE,
CITY BUSINESS
LICENSE NO..
GRADE/{�
EXCAVATE
�i,,
r`�F (•TKI�D I?�ICI x
(D / ( 3 Z v
W1t-� Ma►L
Ilk, ,C :2 -74,5j4
P76e
PIPELINES
CEMENT/
FOUNDATIONS
CEMENT/WALKS
& DRIVES
'ASPHALT
FRAMING
STEEL/
STRUCTURAL
MASONRY
PLUMBING-.GAT0
L) L.0 1Nio<.
DRYWALL
IP
sP2
1X47y'y 1
7a (o
HVAC��WcS-T�. (2
462cO s S q
Ye S 7
zo
ELECTRICAL
(D%-?? 3q
ROOFING
SHEET METAL
FLOORS
GLASS/
GLAZING
INSULATION
SEWAGE DISP
PAINTING/
DECORATING
TILE
--
CABINETS/
INSTALLATION
'
ORNAMENTAL
METAL
FENCES/
BLOCK WALLS
HAMILTON P`IA.SD►V��''�
r-
C
LANDSCAPING
OTHERS