05512 (SFD)i
Building
Address
ing
s
P.O. BOX 1504 N u .
78-105 CALLE ESTADO .
481-112 Vi6ta Mello LA QUINTA, CALIFORNIA 92253
rye ucaa
9010 Corbin Ave* .S#3,
City Zip Tel.
#
"Northridge 913.24 8181/349-.5494
Contractor
.Address*.
77-2030 Minnesota
City Zip
I • Palm- Dese rt 92260
Slate Lic.
& Classif. 11 19530
Arch., Engr.,
Designer
Tel.:
9/145-5430
City
Lic. # 260
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
11 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. _ y.
rte'
%SIGNATURE' GATE
\ OWNER -BUILDER DECLARATION
reby affirm that I am exempt from the Contractors License Law for the following
reasowlec. 7031.5,Busohess and Pmfessions 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 lie a signed statement that he is licensed pursuant to
the provisions of the Contractors License Law,•Chapter 9 (commencing with Section 7000) of
Division 3 of 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 applicant for a permit
subjects the applicant to a civil penally of rat 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, Suisness and
Professions Code: The Contractors 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 of sale.)
O I, 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 contractors) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec. w_ & P.C. for this reason
Date Owner
WORKER' 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 No. Company -
❑ Copy is filed with the city- ❑ Certified copy is hereby furnished.
CERnFICATE OF EXEMPTION FROM
WORKED' COMPENSATION INSURANCE
(This section need not be completed ff the perm is for one hundred dollars (8100) valuation
or less.)
I certify that in the performance of the 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. ff. after making this Certificate of Exemption you should become
subject to the Workers' Carpensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
I I
t
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, Cin? Code.)
Lienders Name
Lenders Address
f 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
J
BUILDING: TYPE CONST. OCC: GRP.
A.P. Number
Legal Description' 61
Project Description Plan 6
05512
Sq. Ft- 5 No. No. Dw.
.Size -Stories Units
New E} Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
$ 1U4,139.ti0
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
S Cf • f,
Const.35
.-uu
Mech.
.`
Electrical
.3
Plumbing
f26.50
S.M.I.
.3
Grading
Driveway Enc..
Infrastructure
2,..I3_
Fr%gee—toed3
.
TOTAL
REMARKS
In-Iiesfxr".te�ix t::c2Ct a -»i Y c►? ��x ice)
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
3/14/89
Issued by: Date Permit
Validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
A.C. UNIT
T
c d
SLAB GRADE / �I/ �L
1ST FL. SQ. FT. ® $
UNITS '
HEATING (ROUGH)
2ND FL SQ. FT.
FORMS
YARD SPKLR SYSTEM
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SO. FT, ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CARP. SQ. Fr. ®
GROUT
WATER HEATER
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE: Not to be used as property tax valuation
FRAMING
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
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 V. c
SEWAGE DISPOSAL
INSULATION/SOUND
SQ.FT.GAR ® 3/4c
HOUSE SEWER
FINISH GRADING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE fL.CK.FEE
CONST. FEE ELECT. FEE
SMI FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
r�T 4^ -
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
c d
SLAB GRADE / �I/ �L
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF.y/�
�Rl
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FAL INSPa
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING �D�/lI :�AA
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS.
GARDEN WALL FINAL
CON Of LA GUINTA
OF
DEPARTMENT OF PLANNING & DEVELOPMENT
► BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS
Abe & Thelma Grossman
Own*er
Contractor Tames cz r_' r.aqb.man
Permit Number 05512
POST ON JOBINCONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE SPACES
JOSAIDDRIESS 48-112 Vista Cielo
TYPE OF INSPECTION DATE. INSP.
FOUNDATION & SETBACK
FOOTING STEEL
MAIN GROUND SYSTEM 4
GROUND PLUMBING w 2617 Go?,
PRE-GVNITE.
DO NOT POUR CONCRETE UNTIL.ALLAPOVE)iASS EN SIGNED
CONCRETE SLAB 2- A67,2, 162-
JOiSTS & GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
ROUGH ELECTRIC
ROUGH PLUMBING
ROUGH GAS & GAS TEST
HEATING & VENT - A/C
FIREPLACE
ROOF
BOND BEAM
O.K. TO WRAP
r ZZr�- e�_ �-
GROUT 0 4' 0 8'
FRAMING
r pj79?
INSULATION
PRE -ROOF
COVER NO WORK UNTIL ABOVE HAS BEEN SIG ED
DRYWALL. !NTERIOR,
EXTERIOR LATH'
POOL PRE PLASTER
POOL FENCE 9, GATE
SEWER SEPTIC TANK
FINIALS
ELECTRICAL
L2 -
PLUMBING
FINAL GAS TEST
HEATING - AIC
HOUSE NUMBERS
JOB COMPLETED
3U
TEMP POWER
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO
TURN ON UTILITIES OR OCCUPY BUILDING
4!88