003226 (SFD)Building
Address 54-832 inverness
Owner
suxsal: ise company
Mailing
Address
City Zip
Ptklz±19>>lply a _i3n
Contractor
-Address . . _.—
Zip
State Lic.
& Classif. • 289130
Arch., Engr.;"
Designer
Address
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No.
0.03226
BUILDING:' TYPE CONST. OCC: GRP.,
')r iVA A.P. Number 'ASA fy Itt*
Legal Description
Project Description Aheexa 147k 131 grin 7X,!1V
r_:1s a+rTc
Tel..
City DWG.1672
Lic. # .328 Sq. Ft.No. No. Dw.
Size' ' GAS. - -424 Stories Units
New ❑ Add ❑ Alter ❑. Repair ❑ Demolition ❑
Tel.
City Zip State
Lic. # -
�' J LICENSED CONTRACTOR'S DECLARATION
I hereby affirm"that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of thetBusiness and Professions Code, and my license is in full force and
effect�.:/�.� �df .� Iii fJ �fi ✓ !l�' %
_ 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
Estimated Valuation
$1t9162
5 00
permit. to construct, after, 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
the provisions of 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
' subjects the applicant to a civil penalty of not more than'five'hundred dollars ($500).
O 1, as owner of the property, or my employees with wages as their sole compensation, will
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and '
Professions Code: The Contractor's License Law does not apply to an owner of property who
PERMIT
...
•AMOUNT
. k
Plan Chk. Dep..
-
Plan Chk. Bal.
Q
Const.
A A1 (IA
Mech.
Af (1 0
builds or improves thereon and who does such work.himself or through his own employees,
provided that' such, improvements are not intended or offered for sale. If, however, the building
Electrical
or improvement is sold within one year of completion, the owner -builder will have the burden
of proving that he did not build or improve for the purpose of sale.)
Plumbing
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con.
struct the project. (Sec. 7044, Business and -Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
❑ I am exempt under Sec. B. 8 P.C. for this reason
S.M.I.
-
Grading
Driveway Enc.
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' I hereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. ' ' . Cornpany
O Copy is filed with the city. O Certified copy is.hereby furnished.
TOTAL
. , .. :1�.•�- C q
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
REMARKS
tl Yytl1W i L3 d ± £$;►9
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.) -
I certify that in the performance of thg 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, 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
ZONE: BY:
Minimum Setback Distances:
Front.Setback from. Center Line
Rear Setback from Rear Prop. Line
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.)
Side Street Setback from Center Line
Side Setback from Property Line
Lender's Name
FINAL DATE
INSPECTOR
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.
Issued by:
Validated by:
Date 7 115 l q'Permit
-
Signature of applicant Date
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SO, FT, ®.
GAR. SQ, FT, ®
CAR P. SQ. FT.
WALL SQ. 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
UGH PLUMB.
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
FOUND. REINF. , 2 J
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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
SQ.FT.GAR p 3/ac
HOUSE SEWER
=$
LUMBER GR.
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 PLUMBI G
d UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE / 76�7
UGH PLUMB.
41
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC T
/`- ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF. , 2 J
AS (ROUGH) / MV 7 ER LOOP
l .
HEATING (FINAL)
OTHER APP.IEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
$
GRADING
cu. yd.
P lus x$
=$
LUMBER GR.
FINAL INSP.
/ �/ /Q
FRAMING /o /7--f4o` r
elf INAL INSP. U
,
ROOFING �Q
O ��
I/ //Z /g
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING .,P
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL