9581 (ELEC)44
P.O. BOX 1504 N o . 9581
Building . 78-105 CALLE ESTADO
Address 44290 Vilieta Drive LA QUINTA, CALIFORNIA 92253
Owner
f'a ` Vista Partnersi BUILDING: TYPE CONST.
Mailing OCC: GRP.
Address P. {jam Box 227
A.P. Number
City Zip Tel.
La Quinta 28253 360-1619 Legal Description Lot � '3
Contractor. Project Description iemD Power Pole
La Quinta Vista Partnership
Address
f3 ci�iRa
City Zip Tel.:
State Lic. City
& Classif. 5303.6 Lic. # 1614 Sq. Ft. No. No. Dw.
Arch., Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address ti Tel.
4i`,1
y
City Zip State "
Lic. #
a1 LICENSED CONTRAG OR'S DECLARATION -
Livere yy,, m the l am li ensed under provisions of Chappte�(commei Ing with- Sectton
7000) . Division. f the,einess and Professions C�de15nd my license is in fJ�l oice and
effect.f� K,t/�.
SIGNATOR •••!!! ___ DATE
OWNER -BUILDER DECLARATION '
I hereby affirm that I am exempt from the Contractors License Law for the following Estimated Valuation
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure; prior to its issuance also AMOUNT
requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 or 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 permitPlan Chk. Dep.
subjects the applicant to a civil penalty of not more than five hundred dollars.(8500)
❑.1, as owner of the property, or my employees with wages as their sole compensation; Will Plan Chk. Bal.
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 3 .
Professions Code: The Contractor's License Law does not apply to an owner of property who
00
builds or improves thereon and who does such work himself or through his own employees, IMech.
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 wig have the burden Electrical � � 1$
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- Plumbing
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 S.M.1.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. 8P.C. for this reason
t Driveway Enc.
Date Owner Infrastructure
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.)- :Sti' e"9 i `? Sri '9_iF(3 :4
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. V' ! �. ��
TOTAL 3.3 50
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.)
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: If, after making this Certificate of Exemption you should become ZONE: �BY:
subjectto the Workers' 'Compensation provisions of the Labor code, you must forthwith Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
Front Setback from Center Line
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, Civil Code.)
Lenders Name
Lender's Address
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
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: Date Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES►
1ST FL. SO. FT. ® $
UNITS
SLAB GRADE
2ND FL SO. FT.
BONDING
YARD SPKLR SYSTEM
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. Sp, FT. ®
POWER OUTLET
ROOF DRAINS
CAR P. Sp. FT. ®
GAS (ROUGH)
DRAINAGE PIPING
WALL Sp. FT.
OTHER APPJEGUIP.
DRINKING FOUNTAIN.
SO FT ®
TEMP. POLE
URINAL
ESTIMATED CONSTRUCTION VALUATION $
GROUT
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SYSTEM
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
INAL INSPY
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'A c
SEWAGE DISPOSAL
GAR. FIREWALL
SO.FT.GAR ® Wic
HOUSE SEWER
LATHING
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE
MECH.FEE PLCK.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 APPJEGUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
INAL INSPY
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION•
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
r j{ } ..L•� 1
Temporary Power Pole
CITY Of: LA QUINTA
OF DEPARTMENT OF PLANNING & DEVELOPMENT',
y BUILDING DIVISION
564-2246
24-HOUR NOTICE FOR INSPECTIONS '
Owrw;' .. La Quinta Vista Partnership
Contractor same
Pormit.Number 9581
POST ON JOB- IN CONSPICUOUS PLACE
INSPECTOR MUST SIGN ALL APPLICABLE 'SPACES
JOB ADDRESS .44-290 -Villeta-, Drive
r "TYPE OF INSPECTION DATE INSP.
FOUNDATIONBSETBACK.
FOOTING STEEL
MAIN GROUND SYSTEM
GROUND PLUMBING
PRE-oGUNITE'
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED
CONCRETE SLAB
JOISTS 8 GIRDERS
ELECTRICAL GROUND WORK
DO NOT POUR CONCRETE UNTIL ALL ABOVE HAS BEEN SIGNED: .'
ROUGH ELECTRIC ..
ROUGH PLUMBING
ROUGH GAS 8 GAS TEST
HEATING &VENT = A/C.
FIREPLACE
ROOF
BOND BEAM,..
O.K. TO WRAP '
GROUT .O 4' O. 8' .
FRAMING;
INSULATION
PRE-ROOF
COVER NO WORK. UNTIL ABOVE HAS BEEN SIGNED = '
DRYWALL INTERIOR
EXTERIOR LATH
POOL PRE PLASTER
POOL FENCE & GATE
SEWER SEPTIC TANK
f FINALS
ELECTRICAL
PLUMBING
FINAL GAS TEST
HEATING.- A/C ry
HOUSE NUMBERS
JOB COMPLETED:
TEMP POWER '
ABOVE APPROVALS DO NOT INCLUDE RIGHT TO'
TURN ON UTILITIES OR OCCUPY BUILDING
ti - f
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