003232 (SFD)T0 1414 . CV
4hf 0901�A
P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 54-844 Inverness LA QUINTA, CALIFORNIA 92253
Owner -� ~ � � Y .•
Mailing
Address
City - - Zip ` _]Tel.
. Palm Desert 92'26C 558=2828
D Contractor
Address .
State Lic.
& Classif. 280130
Arch., Engr.,
Designer
Lic. # 328
No. 003232
BUILDING:.TYPE CONST. OCC. GRP.
A.P. Number We -at
Legal Description
Project Description Phawt, 216.A, Pi" Imi
Sq. Ft. DWG- 1330 No. _
Size p i Stories
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
No. Dw.
Units -
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I•am licensed. under provisions of Chapter 9 (commencing with Section
7000) of Division 3 ohthe Business and Professions Code, and my license is in full force and
effect. %/•; f i .� –I : t/ 1- –711111,1
' 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
194.2-44-00
�
reason:, (Sec,_ and Professions city or county which requires a
permit to construct, alter,'improve, demolish, or repair any structure, prior to its•issuance also
�� •
requires the applicant Jor 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 Section 7031.5 by any for
Plan Chk.. Dep:
of applicant a permit
subjects the applicant to a civil penalty,of not more than five hundred dollars ($500).
I,
.,Plan Chk. Bal. 342 49
❑ as owner of the or m . em to ees with wages as their sole compensation will
property, y p y 9 p
• do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The
•
: l� ��
Const. 51
. Contractor's License Law does not apply to an owner of property who
builds or improves thereon and who does such work himself orthrough his own .employees,
_ •
"Mech. ��. ;�
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 - 119.
of proving that he did not build or improve for the purpose of sale.)
t 7�
0 I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing 87 • 50
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.I.-• 62
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.
Dale owner
Infrastructure 1,413.66
WORKERS' COMPENSATION DECLARATION
' I Hereby affirm that'] 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
O Copy is filed with the city. ❑ Certified copy is hereby furnished..
TOTAL S2,362.26
CERTIFICATE OF EXEMPTION FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permft 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�.:��►i�
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
comply with such provisions or this permit shall be deemed revoked.
.
Minimum Setback Distances : '
Front Setback from. Center Line
Rear Setback from Rear. Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3 09 7, Civil Code.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
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.'
Issued by: Date 7/16/87Permit
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
--Date—
'Mailing
Mailing Address
Validation:
State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO..FT. ® $
2ND FL. SQ. FT. ®
POR. SQ. 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
' O
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SQ. FT. ®c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID Q 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FINAL INSP.
ROOFING
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
SETBACK
GROUN P UMB N
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �y
' O
ROUG(l L g,
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER O TI TA
WRINGROUGH RING � �
DUCT WORK
ROCK STORAGE
FOUND. REINF.a 2
GAS (ROUGH) ,1 `
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
, 101 " cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. j?i ,p
FRAMING fJ it,
FINAL INSP.
ROOFING
VENTILATION
bi
, j
/
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING D i l
MESH d
INSULATIONISOUND
!/
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE - FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL