06668 (SFD)0 44 0
P.O. BOX 1504 N o . 06,668
Building 78-105 CALLE ESTADO
Address 7P ft, % Vill ita Dr- a, LA QUINTA, CALIFORNIA 92253
Owner
Mailing
Address 74-923 Novley 0130
City Zip Tel.
. i'alm. desert 1 92260 1 340-91,7.4
Address
State Lic. City
& Classif. 505699 Lic. # 1383 +
Arch., Engr.,
Designer
Address Tel.
City I Zip I State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
1affiant tm l
haiicensed under provisions ofrChapter 9 (commencing with Section
7000) of bivisibn 3 of'the Business and Profession§ C�oteind my license is in full force and
effectfi'
1 hereby affirm that I am exempt from the Contractor's License Law for the following
reaSOM (Sec. 7031.5,Bnsiimess and Professions Code: Any city or county which requires a
penmT to construct, after, -improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed .pursuant to
Me provisions of the Contractor's License Law, Chapter 9 (commencing. with Section 7000) of
OMsion 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis
for the afeged exemption. Any violation of Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty of not more than rove 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, Buisness and
Professkns Code: The Contractor's License Law does not apply to an owner of property who
&chits 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 irrprovernent is sold within one year of completion, the owner -builder will have the burden
of Proving that he did not Maid or improve for the purpose of sale.)
❑ 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 projeds with a contractor(s) licensed pursuant to the Contractor's License Law.)
O 1 am exempt under Sec B. & P.C. for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
hereby affirm that 1 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
L1°Copy is.filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This sectionneednot be completed if the permit is for one hundred dollars ($100) valuation
or less.)
certify that in the performance of thF 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
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
coney with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
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 abuilding permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 100 days.
1 certify that l have read this application and state that the above information is correct.
I'agree to'compty 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
BUILDING -TYPE CONST: OCC: GRP.•
A.P. Number. L& QU#ta Uwads "Tig 23269
Legal Description
Project Description SFD P1= D—R Lot 153
REMARKS Y
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
Issued by: Date 11/17/89 & Permit
Validated by:
Validation:_
Sq. Ft. 1813 No.
Size ^Stories•'- •
No. Dw.
Units
New ❑ Add ❑ Alter ❑
Repair ❑ Demolition ❑
Estimated Valuation
$100,293
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
It 53-5,34
Const.
643.00
Mech.
60.00
Electrical
109.84
Plumbing
132.50
S.M.I.
Grading
Driveway Enc.
Infrastructure
2,255.59
TOTAL
REMARKS Y
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
Issued by: Date 11/17/89 & Permit
Validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ) • ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE (1
YARD SPKLR SYSTEM
2ND Fl. SQ. FT. 0
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF. t�/> ,
POWER OUTLET
ROOF DRAINS
GAR. SO. FT. ®
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL) G .9
(/
DRAINAGE PIPING
CARP. SQ. FT. ®
GROUT
WATER HEATER
DRINKING FOUNTAIN.
WALL SQ. FT.
BOND BEAM
WATER SYSTEM
URINAL
SQ. FT.
_$
LUMBER GR.
ESTIMATED CONSTRUCTION.VALUATION $
FRAMING ? g
WATER PIPING
NOTE: Not to be used as property tax valuation
f r/J
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
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ec
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
SETBACK
GROUND PLUMBIN O
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE (1
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. t�/> ,
f
GAS (ROUGH) L j t49
ETER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL) G .9
(/
EMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING ? g
FINAL INSP.
ROOFING
f r/J
t�/n
o
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING it j_,,
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL