003430 (RER)44
P.O. BOX 1504 No.. .003430
Building 78-105 CALLE ESTADO
Address 49-520 VISTA Rd-A LA QUINTA, CALIFORNIA 92253
Owner
Ah-DEN/LA, QUIUTA JOINT VENTUrm BUILDING: TYPE CONST: OCC:.GRP.
Mailing'
Address gd BOX 780 A.P. Number 773-350-009
City ZipTel.
LA
QUMIA 92253 5644 1325. Legal Description 9
Contractor Project Description RWAIR FM DsV.k G
Address _.
City Zip Tel:. _. .
State Lic. City
& Classif. Lic. # j" Sq. Ft. - No. No. Dw.
3337E+2 i-3 s
Size = Stories . • Units
Arch., Engr., . ....
Designer New:❑ Add ❑ Alter ❑. Repair ❑ _ Demolition O
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION "
I hereby affirm that I am licensed under provisions of. Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNA...
TU
f>a.RP^•"
- - "•^ re+•- /.d' •� `+' DATE
OWNER.BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation �3
reason: (Sec. 7031.5,Business and Professions Code: Any city or"county which requires a - 25.'Ile^ttx
0 0 _
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 o/ the Contractor's License Law, Chapter 9 (commencing with Section 7000) of _ .+• . .
'Division 3 of 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 .permit' Plan�Chk: Dep.
subjects the applicant to a civil penalty of not-more than rive hundred dollars ($500):`- - ,
❑ I, as owner of the property, or my employees. with wages as their sole compensation, willPlan Chk.-BBL
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const.7J�
Professions Code: The Contractor's License Law does not. apply to an owner of property ,who e
00
builds or improves thereon and who does such .work himself or through his own employees, .�
Mech. _
- provided that such, improvements are not intended or offered for, sale. I/, however, the: building • ,
or improvement is sold within one year of completion, the owner-builder will'have. the burden
EIBCtrICal -�.�
of proving that he did not.build or improve for the purpose of sale.) " . , o . -
00
❑ I, as owner of the property, am exclusively contracting with .licensed contractors to con- Plumbing -' 110.
struct the.
project. (Sec. 7044, Business and Professions Code: The Contractor's License Law R
does not apply to an owner o/ property who builds or improves thereon, and who contracts for $, M.I. �'i3
-
-such projects with a contractor(s) licensed pursuant to the Contractor's License taw.)
Grading
O 1 am.exempt under Sec. B. 8• P.C. for this reason
Driveway Enc.
Date owner Infrastructure
WORKERS' COMPENSATION DECLARATION
• I hereby affirm that I .have a certificate of consent to self-insure, ora certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.' Company
❑ Copy. is filed with the city. .Q Certified copy is hereby furnished.
TOTALf
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'.COMPENSATION INSURANCE : -
(This section need not be completed i/ the permit is -for one hundred dollars ($100) valuation - •
or less.) . - . ... - ....._
certify that in the performance of thg work for which this permit is issued, I :shall not r,7 g•; £,? ; t3 "X ''4 , ,•„"_� _.? X n
employ any-person in any manner so as to become subject'to the Workers' Compensation 3 r -- , y ti 'Y .
Laws of California. x 03 W Tia'f'tZli I— i t Ar, r„�Cr +, e Y
Date Owner ”
NOTICE TO APPLICANT:. if, after making this Certificate o/ Exemption you should become ZONE: BY:
Subject to the' Workers' Compensationprovisions of the- Labor Code, you mustforthwith
comply 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
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.), Side. Setback frOffl' Property Llne
Lender's Name
”. Lenders Address FINAL DATE INSPECTOR
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 stale that the above information is.correct.. Issued by: Date Permit
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. Validated by:
Signature.of applicant Date
Mailing Address Validation:
City, State, Zip
HARD COPY
T
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SO. FT. @
POR. SQ. FT. @
GAR. SO. FT. @
CAR P. SO. FT. @
WALL SO. FT. @
SQ, 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/nc
HOUSE SEWER
REMARKS:
VENTILATION
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
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 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
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