05513 (SFD)et lc&x J'
"9 48-1I4 Vista Gala
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No. 05513
owner
Abe & Thel= TheGrosffIIti3'!3
BUILDING: TYPE. CONST. �.00C: GRP.
Mailing
Address 9014 Corbis Ave. S.3
A.P. Number 6.17--W--062
Legal Description62
Lot�rtbr
Project Description PUM 6
Ci tyZip
:d .
�ii.3
Tel..
2181349-5894
Contractor jams C. car i1
Address
alleged exemption: violation of by applicant for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars (5500).
I 77-200 _
City
Zip
Tel.:
f. Palm T)esert
92260
�iI9/��5-S43i3
0 •�
State Lic.
City
& Classif.. $ 195333
r - '
Lic. # 200 -
Sq. Ft. No. No. Dw.
Size. - 7 Stories Units
Arch., Engr.,
Designer
New(R Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
ofproving that he did not build or improve for the.purpose of sale.)
City; I
Zip I
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 - C DATE
OWNER -BUILDER DECLARATION K
I.hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. - 7031.5,Business and Professions Code: Any city or county which requires a
Estimated Valuation 8104,139.40
Pam* to construct, after, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to Ra rite signed statement that he is licensed pursuant to
PERMIT
AMOUNT
the provisions of the Contractor's 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
lot the Any Section 7031.5 'any
Plan Chk. Dep.
-
alleged exemption: violation of by applicant for a permit
subjects the applicant to a civil penalty of not more than rive hundred dollars (5500).
Plan Chk. Bal.
, • 73
0. 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
Const:
0 •�
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds orenproves thereon and who does such work himself or through his own employees,U
Mech.
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
Electrical
y
- .J
ofproving 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-
Plumbing
126.50
struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law
does
7.35
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.)
S.M.I.
Grading
13 I am exempt under Sec B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
2,343.13
Fringe.—toed13
. (ifs
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No Company
I ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
�
TOTAL
CERTIFICATE EXEMPTION FROM
WORKERS'COMPENSATION
NSATION INSURANCE
REMARKS
x r;r.
(This section need not be completed If the permit is for one hundred dollars ($100) valuation
=•'°V �'T 1"`y r r. • -+ v r .: � w� ..� _. _,
or less.) .
I 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: it, alter mating this Certificate of Exemption you should become
ZONE:
BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances:
r
�
Front Setback from Center Line
I
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
FINAL DATE
INSPECTOR
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.
3114189
;l certify that I have read this application and state that the above information is correct.
Issued by:
Date Permit
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.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City; State, Zip
.
1
CONSTRUCTION ESTIMATE
NO. .ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
UNITS
COLL. AREA
2ND FL SQ. FT.
�y
�T
YARD SPKLR SYSTEM
BONDING
MOBILEHOME SVC.
BAR SINK
POR. Sp. FT. ®
Of
SEWER OR SEPTIC TANK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF. F�C%�
GAS (ROUGH)
DRAINAGE PIPING
CAR P. SQ. FT.
OTHER APPJEQU1P.
REINF. STEEL
WALL SQ. FT.
GAS (FINAL)
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
WATER HEATER
WATER PIPING
NOTE: Not to be used as property tax valuation
.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
INAL INSP.
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRYTRAY
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.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
HOUSE SEWER
LATHING f oI" Q Q
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 R AIR COND. SOLAR
SETBACK
GROUND LUM ING�
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE S j
�y
�T
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
Of
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF. F�C%�
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQU1P.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -plus-x$-=$
LUMBER GR.
INAL INSP.
FRAMING �� ,
NAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALnL�
LATHING f oI" Q Q
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS -
GARDEN WALL FINAL
1