05517 (SFD)P.O. BOX 1504
Building
Address 48-12 3 VUta Ciele LA QUINTA, CALIFORNIA 92253
Owner
I Abe S Thelma Groam=
Mailing
Address 9010 Corbin Ave. S.3
City Zip Tel
I parthridge - 91324 €3181449-5894
Contractor
1. . Jags G. Cashman
Address
I . .77-200 Kinllaeac►ca
City Zip Tela
Palo Desert $2260 6191345-5 530
No. 05517
BUILDING: TYPE CONST.- - OCC: GRP.
A.P. Number 617.640.065
Legal Description Lot 65
Project Description 4
" State Lic.
B.Classif. $ 195333
City
Lic. # 260 .
Sq. Ft. 5��.
No. No. Dw.
Arch., Engr.,
Size .�
Stories Units
Side Street Setback from Center Line
Designer
New R Add ❑
Alter ❑ Repair ❑ 'Demolition❑
Address'
Tel.
INSPECTOR
3/14/89
Issued by;
Date Permit
Validated by:
city
Zip
State
Lic. #
{ LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter.9 (commencing with Section
70011) of Division 3 of the Business and Professions Code, and my license is in full forceland
.
t
effect r"1?Yw..l :.J /.%�". •'.. y��fiJv i .r'Zo.:/.�.a� s ^ �,! <f/d`-,% F ,!
SIGNATURE !" - 'DATE
•�_ OWNEWBUILDER DECLARATION
I hereby'affirm that I am exempt from the Contractors License Law for the following
Estimated Valuation
$82,143.00
reason: (Sec. 7031.5,13usiness and Professions Code:, Any city or county which requires a
permit to construct. after, i nprove, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit tone a signed statement that he is licensed pursuant to
PERMIT
AMOUNT
Me provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) -of
DYfsiion 3 of the Busmess and Professions Code, or that. he is exempt therefrom, and the basis
' for the afted exemption. Any violation of Section 7031.5 by 'any applicant for a permit
Plan Chk. Dep.
.�
subjects the aPpficant to a civilpenalty of not more than five hundred dollars ($500).
Plan Chk. Bal.
`, L
\. a. 0471 .92
❑ 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
COf1St�.��
Rofessans Code: The Contractor's License Law does not apply to an owner of property who
.
bmdds or inproves thereon and who does such work hnnseff or through his own employees,
Mech.
G
60.
provided that such improvements are not intended or offered for safe. 0, however, the building
or improvement is solo within one year of completion, the owner -builder will have the burden
Electrical
;;Z ; 9tii.�'3'
of proving that he did not build or bnprove for the purpose of safe.) -
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
120.50
struct the project.'(Sec. 7044. Business and Professions Code: The Contractor's License Law
does riot apply to an owner of who builds or hnproves thereon, for
- S.M.I.
p -
5..81
property and who. contracts
such projects with a contractors) licensed pursuant to the Contractor's License Law.)
i
-
Grading
❑ 1 am exempt under Sec B. & P.C. for this reason
I
Driveway Enc.
Date owner
Infrastructure
1,8413.
#
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workers Compensation Insurance, ora certified copy thereof. (Sec. 3800,. Labor Code.)
Poli . No Company
Copy is filed with the city. ❑ Certified copy is hereby furnished.
.
TOTALr.j''11r�
1 CERTIFICATE OF EXEMPTION FROM
I WORKERS' COMPENSATION INSURANCE
(This section need not be completed Il the permit is for one hundred dollars ($100) valuation
or less.)
I I 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 APPLICANT: f1, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
oompfy wfth such Provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1hereby 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 building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 100 days.
'.1 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
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
3/14/89
Issued by;
Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. $
UNITS 4 '
SLAB GRADE q-;; Q9� l
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK -
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)
TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT. ®
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
FINAL INSP.
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
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING:
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
LATHING wfv D
MESH
INSULATION/SOUND
FINISH GRADING
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 1 Ve c
SEWAGE DISPOSAL
SQ.FT.GAR ® V4c
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 FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
49
SETBACK
GROUND PLUMBING
01 UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE q-;; Q9� l
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
DUCT WORK
ROCKSTORAGE
FOUND. REINF. I -P
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.
FINAL INSP.
FRAMING
INAL INSP.
ROOFING
��•1f
ry,
Oma/
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL�[��
LATHING wfv D
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTIO
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL