003220 (SFD)Building
Address 4 A—
Owner
Mailing
Address 75=-005 Cc
City Zip
.... Pal . Desert I
Address
City
State Lic.
& Classif. 2AR11
Arch.,'Engr.,- -
Designer
9226,
P.O. BOX 1504 No.
�
78-105 CALLE ESTADO
c 20
LA QUINTA, CALIFORNIA 92253
BUILDING: -TYPE CONST. OCC: GRP.Club Dri.ve, .
A.P. Number Vest
Tel.
5£3$-2026 . Legal Description _
Project Description phare , 26A,. Plan 3"
err;a T.An
Tela
City
Lic. #
Sq. Ft. MIG 1627 No.
Size ..:� -A7,•. Stories.,
New ❑ Add ❑ Alter ❑
No. Dw.
Units
Repair ❑ Demolition ❑
Address
Tel.
Minimum Setback. Distances: ,
Front Setback from Center Line
Rear Setback from Rear Prop. Line
City
Zip
State
,FINAL DATE
Lic. #
Issued by:,
Date 7/15s $Permit
•. _ .',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.V : !y i
SIGNATURE -- /. DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following
7031..5,Business Code.; Any
1 pA
reason: (Sec; and Professions ;fly. 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, 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) or
Division 3 ofthe'Business and Professions Code, or that: he is exempt. therefrom; and the basis
for the Any Section 7031.5.by''any for
-
Plan Chk. Dep.
alleged exemption. violation of applicant a permit
.' subjects the applicant to a civil penalty of not more than five hundred dollars (5500). " - ' '1'
Plan Chk. Bal.
❑ 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 offered for sale. (Sec. 7044, Buisness and
Const.,
Ctn nn
Professions Code: The Contractor's License Law does not apply to an, owner of property who
468.00"
468 • ki0
builds or improves thereon and who does such work himself or -through his own employees,
Mech.
_
34.0.0
. provided that' such improvements are, not intended or offered for sale. If, however, the building
or improvement is sold within one year of completion, the owner -builder will•have. the burden
Electrical
i - "
A 1
of proving that he did not build or improve for the purpose of sale.) -
f ,
O I, as ownerof 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
195
- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
-
Grading
❑ 1 am exempt under Sec. B. & 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, 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
urnished.,CERTIFICATE OF EXEMPTION FROM
WORKERS'.COMPENSATION INSURANCE
• (This section need not be completed if the permit is for one hundred dollars (8100) valuation
or less.) _
11 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
subject 'to the Workers' Compensation - provisions or 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 if 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
TOTAL
REMARKS
ZONE:
IHR I <fn4_A'ilW t� Ate^� 6-�i
BY:V7iil . 91
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 7/15s $Permit
Validated by:
Validation:
HARD COPY y -
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT. p
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
S0, 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 It'd T�
FLOOR DRAIN
MECHANICAL FEES
BONDING
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
D
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
DUCT WORK
LAUNDRY TRAY
AIR HANDLING UNIT CFM
AS (ROUGH)
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.
SO. FT. ® c
BATH TUB
WATER HEATER
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
BOND BEAM
SO.FT.GAR ® 3/ac
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 P U BI
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE It'd T�
ROUGH PLUMB. 14)4,
'
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMSff
SEWER OR
D
RO GH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.Z 1 ,R�
I
AS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
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 /Q
FINAL INSP. v'
ROOFING Z
�7
!/
n ey �J
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHINYD 14/
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL .
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL