003235 (SFD)C&tyl
P.O. BOX 1504 No. 003235
Building 78-105 CALLE ESTADO
Address 54-808 InVerness LA QUINTA, CALIFORNIA 92253
Owner " - • - -- - - _.. _ _ - -
BUILDING: -.TYPE CONST. OCC: GRP.
Mailing
Address 75-005 Country Club Drive. . A:P. Number- � WeSt
City Zip Tel.
P8% Dgge92260 —28 Legal Description
Contractor . ' Project Description Phase'26A Pan 4
National Mortgage Land. - -
Address
City Zip Tela
State Lica City
& Classif. IIg1• �t Lic. # 328 _ Sq. Ft. PWG 1918 No. No. Dw.
..Arch., Engr., - _ - -..
Size " GAR 424 Stories" Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
- - Lic. #
�; LICENSED CONTRACTOR'S DECLARATION r
I hereby affirm that'I am licensedunder provisions of Chapter 9 (commencing with Section �n
7000) of Div�is�io•n��3�,of the Business and Professions Code, and my license is in full force and
effect.�'r�2i)
_SIGNATURE - DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I ani 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, alter, 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 PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of. .r
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 five hundred dollars ($500).
❑ I, as,owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. d d 2 73
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COr1St. .4 A
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, Mech. .
provided that such improvements are not intended or offered for .
sale. If, however, the building ;A lin .
or improvement 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.) 7A, A A
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing?
• 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 S.M.1. (�
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. & P.C. for this reason ,
Driveway Enc.
Date Owner Infrastructure 1.992.24
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
0 Copy is filed with the city. ❑ Certified copy is hereby,furnished.
_ TOTALS
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE (A Lnnry�
(This section need not be completed if the permit is for one hundred dollars ($100) valuation }, � �„�,� h�4 Chit3d•,. �7- 6-82...x.• ; i2
or less.) .. - - - .M ri' En1 Y.F Y i. iv E • tli. S wl` Yr.i i a •i'f
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.
Date - owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE:—.BY:
subject to the Workers' Compensation provisions of, the Labor Code, you must forthwith •Minimum Setback Distances:
comply with such provisions or this permit shall be deemed revoked.
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 a construction lending agency for the performance of the
• work for which this permit is issued. (Sec. 3097, Civil Code.) _ Side Setback from Property Line
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration it work thereunder is suspended for 180 days. +s t
I certify that I have read this application and state that the above information is correct. • Issued by: Date ` � -It- � PerfTllt
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 I
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT.
WALL SQ. 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
SLAB GRADE
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
ROUGH WIRING
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
ROCKSTORAGE
LAUNDRY TRAY
AIR HANDLING UNIT CFM
GAS (ROUGH) t!F/ER
IKITCHEN 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
WATER HEATER
SQ: FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
$
GRADING
cu. yd.
plus x$
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 P(UMIXG
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
OUCH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
F MS
TOY
SEWER OR I�
ROUGH WIRING
DUCT WORK
ROCKSTORAGE
` FOD. REINF.
D
GAS (ROUGH) t!F/ER
LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL) it 246
LE
GROUT
WATER HEATER
SERVAE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
plus x$
_$
LUMBER GR.
FINAL INSP. (-2/!
nA Y /
FRAMING /67L
(((///�(
INAL INSP.
ROOFING l D
VENTILATION
l d
`�
afJ�
`
/Z v/
'0'0'.
REMARKS:
FIRE ZONE ROOFING ,
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING io"/ N /or
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL