04972 (SFD)v/
1�414
P.O. BOX 1504 No. 04972
Building 78-105 CALLE ESTADO
Address 54-492 Inverness LA QUINTA, CALIFORNIA 92253
Owner
Address 42-600 took Street, Suite 200
City Zip Tel.
.Palm. Desert 92260 568-282$
Contractor
National Mortgage
Address
State Lic. City
& Classit- 288 130 Lic. # 32$.. .
Arch., Engr.,
Designer
Address Tel.
City IZip I State
Lic. #
LICENSED CONTRACTORS DECLARATION
I hereby aWa m that I am fkmnsed under provisions of Chapter 9 (commencing with Section
700 of Divfsfocn 3 of the Business and Professions Code, and my license is in full force and
effect ✓:• s - /
RQUAT11RE DATE
OWNER -BUILDER DECLARATION
hereby of inn that I am exempt from the Contractors License Law for the following
reason: (Ser~ 7031.5,9trsirress and Professions Code: Any city or county which requires a
permit to construct after rzmprave, demolish. or repair any structure, prior to its issuance also
requires the awffcanr For such pemd to ft a signed statement that he is licensed pursuant to
the pmvissfons at the Contractor's License Law, Chapter 9 (commencing with Section 7000) cf
Division 3 of the Stmihess and Professions Code, or that. he is exempt therefrom, and the basis
far the alleged exempt -on.. Arty vioktion of Section 7031.5 by .any applicant for a permft
subjects the appffiamr to a cndpenally of not more than five hundred dollars ($500).
❑ 1, as carrier of the property, or my employees with wages as their sole compensation, will
do the wank, and the stnicture is not intended or offered for sale. (Sec. 7044, Suisness and
Professions Code: The Cantrdctorls Lice se Law does not apply to an owner of property who
Lxa7ds or leweoves thereon and who does such work himself or through his own employees,
provided that rich improvements are not intended or offered.for safe. If, however, the building
or irrrprovement is solo' within one year of completion, the owner -budder will have the burden
of provirng that he iGd nor build ar improve the the purpose of sale.)
❑ 1, as avmer of the property, am exclusively contracting with licensed contractors to con-
struct the projecL (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 pn*cts with a camractor(s),licensed pursuant to the Contractor's License Law.)
❑ 1 atm exempt under Sec, B. & P.C. for this reason
Date owner
WORKERS COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Workrers Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy NOL -.Company
❑. Copy is fired wfth 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
of tess.)
I Cutity that in the performance of the 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 Califemia.
Date __ diraaar
NOTICE 76 APFUC_1W_ If, after onakerg this Certificate of Exemption you should become
sutyeU to the DttarkeW Cornpensati in provisions of the Labor. Code, you must forthwith
Comply with such pravisians or this permit slraD be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 henry affirm that there is a construction lending agency for the performance of the
work for which this permff is issued (Sec. 3097, CW Code.)
Lenders Name
LendersAddress
This is a buifdfrtgl permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
certify that I have read this application and state that the above information is correct.
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
Sigrtatune of apprirarrt Date
Mailing Address
City, state, zip
BUILDING:,TYPE CONST. d OCC: GRP.•
A.P. Number PGA West - Train 22432-'2
Legal Description
Project Description Phase 268', Flan 30Mq
Sq. Ft. 2825 No: No. Dw.
SiziRA�x'., 568 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
555. 0
Const.
6 7 i 511
Mech.
55,00
Electrical
1
Plumbing
136,50
S.M.I.
11. A2
Grading
Driveway Enc.
Infrastructure.14,390.57
2.1 0.29
to.on Credit
2,190.29
TOTAL
$3.742.72
REMARKS
t1�� ��•n �i%` ah •hr�t7r,�es`a""4� �` a � '�trR �t
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: Datj.2/8188 Permit
Validated
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
FL SO. FT. ® $
UNITS
SLAB GRADE
ROUGH PLUMB.
BONDING
YARD SPKLR SYSTEM
2ND FL. SO. FT.
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
GAS (ROUGH)
METER LOOP
GAR. SQ. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL)_v
TEMP. POLE
DRAINAGE PIPING
CAR P. I SQ. FT. ®
GROUT
WATER HEATER
WALL Sp. FT.
FINAL INSP.
DRINKING FOUNTAIN
SO FT ®
WATER SYSTEM
URINAL
ESTIMATED CONSTRUCTION VALUATION $
=$
WATER PIPING
NOTE: Not to be used as property tax valuation
FINAL INSP.
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
VENTILATION
LAUNDRY TRAY
AIR HANDLING UNIT CFM
FIRE ZONE ROOFING
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
44ZMEHING 4442-
SO. FT. ®c
IWATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/ic
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 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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)_v
TEMP. POLE
GROUT
WATER HEATER
ERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP.
FRAMING �yg'
FINAL INSP.
ROOFING 3 ,
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
44ZMEHING 4442-
SH
MESH
SULATION/SOUND
FINI H GRADING
AL NSPECTIO
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
t