05950 (SFD)4
P.O. BOX 1504 N u .
Building 78-105 CALLE ESTADO
Address 78-720 Via Sonata LA QUINTA, CALIFORNIA 92253
Btarcan Dev•
Mailing A' -
Address 6$-713 Perez lel. # 1 _
City Zip Tel.
Cat City 92234 1 - 773-9026
Contractor
saw
Address
City Inp I Tela
State Lic. City
& Classif. 337077 1 Lic. # 12.19
ueslgner
Address Tel.
City Zip State
Lic. #
r;'. • LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
e0ff00) of Division ,o_ f.th,4&siness and PnoilesMons Code, and my license is in full force and
_SIGNATURE DATE
01YNER-BUILDER DECLARATION
reason: (Sec- .5.achess and Professions, ud I am exempt from the � tors License Law for the following
Arty city or county which requires a
Permit to construct. ate. irprove, derrmo[sf or repair any structure, Prior toits issuance also
requires the aid for such permit to file a signed statement that he is licensed pursuant to
the provisions of the CenbaclorS License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or drat. he is exempt therefrom, and the basis
for the alleged exemption- Any mdcdbon of Section 7031.5 by *any applicant for a permit
subjects the appicant to a a.ipeedy of not mo a than five h ndred 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 Contractees License Law does not apply to an owner of property who
builds or Lmprows thereon and who does such work himself or through his own employees,
Provided that such irproverne ts; are not intended or offered for safe. 11, however, the building
or improvement is sok/ within am year of completion, the owner -builder wig have the burden
of proving that he did not bul d or irprore for the purpose of sale.)
❑ 1, as owner of the properly, am exclusively contracting with licensed contractors to con-
struct the project (Sea 7044, Business and Professions Code: The Contractor's License Law .
does not appy to art owner of property who builds or improves thereon, and who contracts for
such projects with a conhractofs) licensed purnA rd to the Contractor's License Law.)
❑ 1 am exempt Under Sec a g P -C- for this reason
Date Owner
WORKERS COMPENSATION DECLARATION
Workers Com�rm that I have a certificate of consent to self -insure, or a certificate of
pensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No C xnpany
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
VIORKERS' CON 43MTION INSURANCE
(This section need not be completed d the pend is for one hundred dollars (E 100) valuation
or fess.) - '
I certify that in the performance of thip 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: I, - after rnafdrg this Certibcate of Exemption you should become
subject to the Rbrkers' Cmpernation provsios of the Labor Code, you must forthwith
comply wfth such provisions or this pemd shat be deemed revoked.
CONSTRUCTION LENDING AGENCY
Ihereby affirm that Mere 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 building permit when property 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
05960
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description Phase T-iI Lot 16
Project Description Plan 2222 Pare '!rel Onittta
Sq. Ft. 2222 No. No. Dw.
Size Stories Units
NeWXX Add ❑ Alter ❑ Repair ❑ Demolition ❑
.i
stimated Valuation
112,1fi1.
Minimum Setback
PERMIT
AMOUNT
Plan Chk. Dep.
Rear Setback from Rear Prop. Line
_
Plan Chk. Bal.
Side Setback from Property Line
Const.
FINAL DATE
685.01
Mech.
6-16-89
60,00
Electrical
"` '
M • o'
Plumbing
"•��
p• -
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
V 112. .3
REMARKS
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
6-16-89
Issued by:
Date Permit
Validated by:
Validation:
(/�
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADEQ
ROUGH PLUMB.
YARD SPKLR SYSTEM
2ND FL SO. FT. ®
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT. ®
DUCT WORK
ROCK STORAGE
FOUND. REINF.
POWER OUTLET
ROOF DRAINS
GAR. SO.. FT. ®
HEATING (FINAL)
OTHER APPJEGUIP.
REIN F. STEEL
GAS (FINAL)
DRAINAGE PIPING
CARP. SO. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL S0. FT.
FINAL INSP.
BOND BEAM
WATER SYSTEM
URINAL
S0. FT. @
GRADING
cu. yd.
—Plus—X$—=$
ESTIMATED CONSTRUCTION VALUATION $
/y
� INAL INSP. _ (� _
C (!
WATER PIPING
NOTE: Not to be used as property tax valuation
ROOFINGfim�r7
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
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.
SO. FT. ® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1+/. c
SEWAGE DISPOSAL
SO.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 FEEtLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
G ND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEQ
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.
S (ROUGH) _4V<
METER LOOP
HEATING (FINAL)
OTHER APPJEGUIP.
REIN F. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
—Plus—X$—=$
LUMBER GR.
/y
� INAL INSP. _ (� _
C (!
F MING ..
FINAL INSP.
ROOFINGfim�r7
v �� J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HING
MESH
L
CATION/SOUND /—JO O
FINISH GRADING
FINAL INSPECTION -
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
`
GARDEN WALL FINAL
t