003532 (SOTB)Building
Address 54-791 I2Ave.rnpRn
Owner
National 140rtgage & Land
Mailing
Address 758005 Coti;'J C2Ub Dr,
City Zip Tel.
als-. Desert' 922610 :.568-
Contractor
Address
P.O. BOX 1504 NO. 003532
78-105 CALLE ESTADO
L�AuQUINTA, CALIFORNIA 92253
BUILDING: TYPECONST. OCC: GRP:
• K - A.P. Number
>$ Legal Description
Project Description Phsae 23B Rest corn Facility
City Zip Tel:
State Lic. City
& Classif. Lic. # Sq. Ft. No. No. Dw.
Arch., Engr.,. . - - - -
Size - Stories - Units
.Designer New ❑ Add ❑ Alter ❑' Repair ❑ Demolition ❑
Address
Tel.
Minimum Setback
Distances:
City
Zip
State
Lic. #
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
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
feet. ��`-i7 it t• - r F` ✓ii-�7. .. r• J �9
FINAL DATE
INSPECTOR
Issued by:
SIGNATURE - DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for 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 81e a signed statement that he is licensed pursuant to - .
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 o/ Section 7031.5 by any applicant /or 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 offeredforsale. (Sec. 7044, Buisness ander
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds oranproves thereon and who does such work himself or through his own employees,
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
of proving that he did not build or improve for the purpose of sale.) .
O 1, 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.) -
❑ I am exempt under Sec. B. &•P.C. for this reason
_
Estimated Valuation
A
11,rgag
'
.PERMIT
< . " AMOUNT
c•
Plan Chk. Dep.
-
Plan Chk. Bal.
$60.12 y
-Const.
2 . 50
Mech.
Electrical
�� ;
Plumbing
36-00
S.M.I. ' • -
- y ,
Grading
Driveway Enc.
,Date Owner
Infrastructure
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.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. .
_.
CERTIFICATE OF EXEMPTION FROM
'WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit is for one hundred dollars ($100) valuation
or less.)' •-
I certify 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 California.
TOTAL
.g7o . 1 j
s
REMARKS
0051.1121 1 P 7UM- 12- 2 1 13f. i
-
-
ate Owner
NOTICE TO APPLICANT: If, alter making this Certificate of Exemption you should become
subject 'to the Workers' Compensation 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 it work thereunder is suspended for 180 days.
I certify 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
HARD COPY
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 $ Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES -:--L ;.,
1ST FL. y SO. FT. @ $
2ND FL. f SO. FT. @
POR. SO. FT. @
GAR. SO, FT, @
CAR P. St]. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
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. 4. B.T.U.
SQ. FT. @ c
BATH TUB
FINAL INSP.
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/4c
HOUSE SEWER
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
�G�SETBACK/�// ��
904rOUND PLUM BIN /'
UNDERGROUND
A.C. UNIT
COLL. AREA
oa,�61-AB GRADE Jf
UGH PLUMB/g/, ��
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
C:- )/-
UGH WIRING/-
OZ/ -
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
RAMING / _
FINAL INSP.
ZOAekOFING ` i�
/ ;�%�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
aeLATHING 3
MESH
INSULATION/SOUND, —'�}`� - CJ�
pa\ 11
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL .,
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL