06673 (SFD)P.O. BOX 1504 No. 06673
Building 78-105 CALLE ESTADO
Address 78-815 Villeta Drive LA QUINTA, CALIFORNIA. 92253
Owner
Triad Pacific Desert Dev.
Mailing
Address
sky
City Zip Tel.
Par3aiDesert 93261 340—.9q74__
� _
Contractor
Address
p I 1 el.:
State Lic. City
& Classif. 505$99 Lic. # 1363
Arch., Engr.,
Designer
Address Tel.
CityI Zip I State
Lic. #
LICENSEWCONTRACTOR'S DECLARATION
I hereby affirm'thatiram licensed under proviSlotis of Chapter 9 (commencing with Section
7000) of Division 3,of the Business anzd=Prof§icifis.Code, and my license iss in fullforceand
effect.
DATI
OWNEWBU1LDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Lawfor the following
reason: (Sec, 7031.5,Business and Professions Code: Any city or county which requires a
permit 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
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or Nat. 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 penalty of not 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, Buisness and
Professions Code: The Contractor's 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.)
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 am exempt under Sec B. & P.C. for this reason
Date Owner
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.)
Po`icy„No. Company
O Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) 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 or Exemption you should become
subject to the Workers' Condensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
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.)
Lender's 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 dertify 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
3UILDING: TYPE CONST: OCC: GRP.
4.P. Number La Quintti Highlands TT 23269
_egal Description
3roject Description Plan D i Lot 154
Sq. Ft. 1813 No. - . - - No. Dw.
Size Stories Units
New ❑ Add ❑ Alter ❑ Repair 0 Demolition ❑
Estimated Valuation
PERMIT
AMOUNT y
Plan Chk. Dep.
.=.
Plan Chk. Bal.
” 535.3
Const.
.D!?
Mech.,
60.00
Electrical `+ 1 ' '
_ .- > 109.84
Plumbing
132.50
S.M.I.
7.07
Grading
Driveway Enc.
Infrastructure 2o256.59
TOTAL $3,744.34
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
.11/17/89
Issued by: Date Permit
Validated by:
Validation:_
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SO. FT. @ $
UNITS
COLL AREA
SLAB GRADE 1-7 s ��
YARD SPKLR SYSTEM
2ND FL SO. FT.
HEATING (ROUGH)
STORAGE TANK
FORMS
MOBILEHOME SVC.
BAR SINK
POR. SO. FT.
DUCT WORK
ROCK STORAGE
FOUND. REINF. �L
POWER OUTLET
ROOF DRAINS
GAR. SQ. FT. ®
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
DRAINAGE PIPING
CARP. SQ. FT. ®
GROUT
DRINKING FOUNTAIN_
WALL SO. FT. ®
FINAL INSP.
BOND BEAM
URINAL
SQ. FT.
GRADING
Cu. yd.
$ plus -x$-=$
ESTIMATED CONSTRUCTION VALUATION $
LUMBER GR.
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
C /)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTOXDISH)
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, 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.
SQ. FT. RESID ® 11A c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSPECTION
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 PLUMBING UNDERGROUND
A.C. UNIT
COLL AREA
SLAB GRADE 1-7 s ��
ROU P MB 9D fXa 3 QBONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. �L
S (ROUGH)
' n
l �(/ / METER LOOP
VVV
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL
GAS (FINAL)Cj� yQ TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
Cu. yd.
$ plus -x$-=$
LUMBER GR.
FINAL INSP.
FRAMING )a (��
FINAL INSP.
ROOFING � ('�/ I Q 1/j
/ �O /7 _ L
A
SK A&-0 OFF
/
C /)
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING J�W
MESH
INSULATIONISOUND T- !
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S
SIGNATURES/INITIALS
GARDEN WALL FINAL71
t