07122 (RPL)44
P.O. BOX 1504 No.
Building 78-105 CALLE ESTADO
Address 78,-705 Via Sonata LA QUINTA, CALIFORNIA 92253
Owner I
.
Mailing
Address '
City La Zip Tel.
Quina 92253 X75-2 i7
Contractor
UUi t PE70i9 by Q=Mine
Address
City IZi
Palo Desert
State Lic.
& Classif. 540432-
Arch.,
540432.Arch., Engr.,
Designer
366-6335. ,
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number Phre L tuftta
Legal Description
Project Description Path & Spay
%A Ly
Lic. # 1366 Sq. Ft.
Size
New ❑
07122
No..No. Dw.
StorieUnits
Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
Minimum Setback Distances:
City
Zip
State
Side Street Setback from Center Line
Side Setback from Property Line
Lic. #'
FINAL DATE
INSPECTOR
LICENSED CONTRACTOWS DECLARATION
1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
Issued by:
Date Permit
7110% of Division 3 of the Business and Profei! sions,Code, and myljce se.is in full f`orrcye nand
+
.+'..•Wry!....__ . f..+«.. d a i _� G"i�` •t', .% Ji%
Validation:
SCHATIniE "'" r N err DATE
OWNEWBUILDER DECLARATION
1 herby affirTn that I am exempt from the Contractors License Law for the following
reason: (Sec- 7031-5,Busness'and Professions Code: Any city or county which requires a
Estimated Valuation �1V�2V�
v
PERMIT
AMOUNT
pent to construct, alter, rrprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such perot to Ire a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of
lirison 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the alleged exe ptiun- Arty violation of Section 7031.5 by any applicant for a permit
subjects the appf'cwd to a avilpeoGy o/not more than Owe hundred dollars ($500).
❑ 1, 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 Contractors License Law does not apply to an owner of property who
bids or irproves thereon and who does such work himself or through his own employees,
provided that such irprorvrrlds are not intended or offered for sale. If, however, the building
or kproverneW is sold wNd one year of completion, the owner -budder will have the burden
of proving Drat he did riot build or repfor the purpose of sale.)
Plan Chk. Dep.
plan Chk. Bal.
Z• ��}
Const.
j('lj� ♦�
•
Mech.
34.00
Electrical
efJt A
2rove 500
Plumbing
24• 00
❑ 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
S.M.I.
• 77
does not apply to an owner of property who burrs or improves thereon, and who contracts for
such projects wilfi a cardrardor(s) ieensed pursuantto the Contractor's License Law.)
❑ 1 am exempt under Sec B. 8 P.C. for this reason
Grading
Driveway -Enc.
(late owner
WORKERS' COMPENSATION DECLARATION
1 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 Na Company
11Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section reed not be completed Tf the permit is for one hundred dollars ($100) valuation
arless-) .
1 certify that in the performance of thg 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 APPL1CANi: B, after matmarg this Certificate of Exemption you should become
sriject to time VAwkers' Compensation provisions of the Labor Code, you must forthwith
comer' with such provf9ors or Ods permit shag be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 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.)
Lenders Name
lenders Address
This is a rm
building permitwhen property filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
1 certify that 1 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
conshuctien, and ,hereby. auftn¢a representatives of this city to enter the above-.
mentioned property for inspection purposes.
Signature of applicant Date'
_Mailing Ackhess
City. -Sffie, tip
Infrastructure
TOTAL. ; - l t✓
REMARKS 1t .�:;; -z `k t�...'ary `�(A r,r -11
3i
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
2/20 /4t')
Issued by:
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL. SQ. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
FOR. SQ. FT. (off
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL)
DRAINAGE PIPING
CAR P. SQ. FT. ®
WALL SQ. FT.
WATER HEATER
DRINKING FOUNTAIN.
FINAL INSP.
URINAL
SO FT ®
WATER SYSTEM
ESTIMATED CONSTRUCTION VALUATION $
GRADING
cu. yd.
plus x$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
FINAL INSP.
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
REMARKS:
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® c
BATH TUB
SO. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
MESH
SQ.FT.GAR ® V4c
HOUSE SEWER
INSULATIONISOUND
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
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
^ter„ ,o
�•/` V 1d Tr- `
!�
`
�`3 d
♦�
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
I