002243 (SFD)P.O. BOX 1504 No. 062243
Building 55-012 Umenvew. 78.105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Mailing
BUILDING: TYPE CONST. OCC: GRP...
Address
-
Address 75-005 iXXTqtXV C312b Dr. A.P. Number
CityZip Tel.
M
�1�'$ Legal Description
Contractor OR
Nati Mbrtgage and land Project Description i'¢i' PLM 30
Address PIVM 7
SMM
City. Zip Tel... _
R,�f11�
State Lic. City DM Zug
& Classif. 288330 Lic. # 32€� � Sq. Ft. �� 568 No. 1 No. Dw. I
Arch., Engr.,.._. .. ..
Size a~ Stories Units
Designer New qt. Add ❑ Alter Or Repair ❑ Demolition ❑
Address Tel.
Dity Zip State
.. . .. . 1. . I Lic. #
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. �. / 1' '. Lf/L 4- kl
BY:
Minimum Setback
Distances:
Front Setback from Center Line
Y
SIGNATURE' •� �' .Y.f+.+ w- r'^ 4�1-,i.i•' I' DATE
O.WNI?R'BUILDER DECLARATION
I hereby affirm that I am exempt from thdContractor's License Law for the following
reason:., (Sec. 7031.5,Business and Professions Code: Any City or County which requires '• a
Dermftsto construct, alter, improve, demolish„or repair any structure, prior to its issuance•also
requires the applicant for such permit to fife' '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 civilpenalty ofnot more than rive hundred dollars ($500).
0 I, as owner of the property, or my employees with wages as their sole compensation, will,
Jo 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
builds or improves thereon and who does such work.himself or through his •own employees,
Drovided that such improvements. are not intended or offered,for sale. If, however, the building
�r improvement is sold within one year of completion, the owner -builder will have the burden
ef proving that he did not build or improve for the.purpose of sale.) -
❑ 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. ti. P.C. for this reason-
Estimated Valuation 178t307.00 �1
17 3�I ryrl
1 f I I • V V
PERMIT ••
z
AMOUNT
-
Plan Chk. Dep_
INSPECTOR
Plan Chk. BBI.
•,i.
Const. -
rr
i7.:Ji'
50
Mech.
30
Electrical
♦♦ -
Plumbing
S.M.I.
12:36
Grading •
Driveway Enc.
)ate owner
Infrastructure
2AID0.00
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
O Copy is filed with the city. 0 Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(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, after 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
Ihereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)•
_ender's Name
.ender's Address
This'is a building permit when properly filled out, signed and validated, and is subject to
mpiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
agree to comply with all City and county ordinances and state laws relating to building
:onstruction, and hereby authorize; representatives' -of this city to enter the above-
mentioned properly for inspection purposes:,
x /
signature of applicant /�i?iv�/ 1�/Jr� J Date r r�
Mailing Address 1 L r % 4
;sty, State, Zip % 4Z f
r
HARD COPY
TOTAL 3,485.17
REMARKS
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 4-7`"85 Permit
Validated by:
Validation:
Ai5100
4 8 3485 17 R
CONSTRUCTION ESTIMATE ''
NO. ELECTRICAL FEE �
NO. PLUMBING FEES
1ST FL. SO. FT. @ $
2ND FL. SQ. FT. @
POR. SQ. FT. @
GAR. SO. FT. @
CARP. 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
BONDING
FLOOR DRAIN
MECHANICAL FEES
/ ORMS 7 %/� �D �j
c�
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEQUIP.
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. B.T.U.
SQ. FT. @ c
BATH TUB
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
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
S BACK
GWD PLUM I .G/
UNDERGROUND
A.C. UNIT
COLL. AREA
�AAB GRADE 27
H PLUMB.S
BONDING
HEATING (ROUGH)
STORAGE TANK
/ ORMS 7 %/� �D �j
c�
OR SE 19, TA Va
— 6 H WIRING �Zp
/
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEQUIP.
REINF. STEEL/Z'
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FkNAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
FINAL INSP. /�1
/(/
/e -FRAMING
IqQ INSP42 /`
c�
ROOFING S `
!/
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING �IG
MESH
�zr-INSULATION/SOUND �, 6
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL