002385 (RER)44
P.O. BOX 1504 No.'��
Building�78-105 CALLE ESTADO
«
Address �. LA QUINTA, CALIFORNIA 92253
Owner
Mailing _ BUILDING: -TYPE C,O%NST.- � - '-^,OCC: GRP.
Address
1296�}
< 12A.P. Number ilk i�
Cly j Zip jTel. /
Contractor
TM it
Address
Legal Description A 0
Project Description
a♦G l we ' pilwchand- MWftl bXi.lit ';ice . .
CRY Zip
Tel.'
Pala VaSeXt 92260
341:x'7335.
State Lic.
City
& Massif. ,,4395592
Lic. # 065 •
Sq. Ft. � No. No. Dw.
Size - Stories.. Units
Arch.; Engr.;.
Designer
New ❑ Add ❑x. Alter ❑ Repair ❑ 'Demolition ❑
Ac dress
Tel.
Ci-YZip
State
-
Lic. #-
LICENSED CONTRACTOR'S DECLARATION
"
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70J0) of Div/isio,�n,3 off the Business and Professions Code and my license is in full force and
-
ef,ect. la '�".�'Yl""F.. �f i:' -•i .�'"
.
SIG"IATUREy �. + C.",-?.. -. F.�, •>,r DATE
.. ..
f{ OWN ER•BUILDER(i)ECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following.
Estimated Valuation
-
reason: (Sec. 7031.5,Business and Professions Code:.Any city or county which requires •a.
'pewit to construct, alter, improve, demolish, or repair any -structure,. prior to its issuance alsoAMOUNT-
- *�-1•
the applicant for such permit to file a signed statement that .he is.licensed pursuant to
'PERMIT
the
the provisions of the Contractor's License Law, Chapter '9 (commencing with Section '7000) or
Divaton 3 of'the Business and Professions Code, or that. he is exempt therefrom, •and the basis.
for the.alleged Any Section 7031.5 by 'any for
-
..Plan Chl(.. Dep. -
exemption. violation of • applicant a permit _
• subjects the applicant to a civil penalty of not more than five hundred dollars ($500). •
Plan Chk.,Bal. 61.8
O , as owner of the property, or my employees with wages as -their sole compensation, will
do , he work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
CO11st..
Proiession_s Coda: The Contractor's License Law does not apply to an owner of property. who
'who
- .
buiids or improves thereon and does such work himself or through. his own employees,
Mech.
proL-ided that such improvements are not intended or offered for sale. 1f, however,. the building
or .nprovement is sold within one year of completion, the. owner -builder will have the burden
Electrical
of proving that he did not build or improve for the purpose.of sale.) -
•�
❑ , as owner of the property, am exclusively contracting with licensed contractors to con-
�e�
Plumbing 26.00
stnact the project. (Sec. 7044, Business and Professions .Code: The Contractor's License Law
'an
does not apply to owner of property who builds or improves thereon, and. who contracts for
S.M.I. - -
•i
suc" projects with a contractor(s) licensed pursuant to the Contractor's License Law:) -
-
Grading
❑ I am exempt under Sec. B. 8 P.C.-for this reason
-
Driveway Enc.
Dat owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
hereby affirm'that I'have a certificate of consent to 'self -insure, or a certificate of
Wcrker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
- -
Poiicy No. - Company - -
IQ Copy is filed with the city. - . ..Certified copy is hereby furnished.
TOTAL 180.99
CERTIFICATE OF EXEMPTION FROMv
REMARKS
WORKERS' COMPENSATION INSURANCE _. .
(Ths section need not be completed if the permit is for one hundred dollars ($100) valuation
or iess.). .. .. _ ..
certify that in the performance of the work for which this permit is issued, I shall not
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employ any person -in any manner'so as to become subject to the'Workers' Compensation
-
Laws of California.
'
Dale—owner _.
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
'ZONE: - BY:
sut_iect to the Workers -Compensation provisions of the Labor Code, you must forthwith-
corvply with such provisions or this permit shall be deemed revoked.
Minimum Setback Distances: -
Front Setback. from. Center Line
Rear Setback. from Rear Prop., Line
CONSTRUCTION LENDING AGENCY.. "
- Side Street Setback from: Center Line
1 hereby affirm that there is's construction lending agency for the performance'of the
wor. for which this permit is•issued. (Sec. 3097, Civil Code.) .
Side Setback from Property Line
Lender's Name
Lender's AddressFINAL
-his
DATE INSPECTOR '
is a building permit when properly filled out, signed and validated, and is subject to .
expration if work thereunder is suspended for 180 days:
I certify that I have
t —�
5
read this application and state that the above information is correct.
+county
Issued by: Date Permit
agree to comply with all city and ordinances and state laws .relating to building
construction, and hereby authorize representatives of this city to 'enter the above-. -
mertioned property for inspection,purposes.
Validated by:
Signature ofapplicantV t f�••i°7� Date
�-:�/ ,:a
Maiing Address_
.
Validation:
City State, Zip f i
'
A 5 6 5 3 t3 .18099 U
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SQ, FT. Q
CARP. SQ. FT.
WALL SO. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
_
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
COLL. AREA
FLOOR DRAIN
MECHANICAL FEES
VOUGH PLUMB. Q
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
FORMS
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
UGH WIRING '
LAUNDRY TRAY
AIR HANDLING UNIT CFM
DUCT WORK
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
WATER HEATER
SQ.FT.GAR ® 3/ac.
HOUSE SEWER
FINAL INSP.
GAS PIPING
PERMIT FEE
WATER SYSTEM
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
VOUGH PLUMB. Q
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
UGH WIRING '
DUCT WORK
ROCK STORAGE
FOUND. REINF. i ;
10
G
/
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
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.
0 FRAMING
FINAL INSP.
ROOFING
,7�Z
((
5,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
HING -716;1
MESH
INSULATION/SOUND 7
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
marc. I V n a munh 1 unCanm 11ww.
GARDEN WALL FINAL
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