003450 (SFD)A'
P.O. BOX 1504 No. 003450
Building 78-105 CALLE ESTADO
Address L jmla ' lKl ^ Ria ,r• s LA QUINTA, CALIFORNIA 92253
Owner
Address 71A 14vi-rIAndst Vista WAV
City Zip Tel.
Contractor
Address
IZip
State Lic. City
& Classif.. Lic. #
Arch., Engr., '
Designer ' �in
Lion �� A -1A
Address #104 Tel.
.. . .5'?52'nbp--rlin Dr%rf b. 619-452-1R60
City Zip State
C aft, SR; r..wr+ . .3 . 17 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.
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
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
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 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
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,
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
of proving that he did not build or improve for the purpose of sale.)
O 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date f/ '? .,'+ :Owner
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,`•L_abor Code.)
Policy No. ' Company `
O Copy is filed with the city. , ❑ 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 th0 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
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
HARD COPY
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number PGA West
Legal Description
Project Description Sitxa r.F3t?14 1.v 1)",is11.inef
:~7 t'rvrYy: JUU
ZONE:
BY:
Minimum Setback Distances:
Front Setback from Center Line
Sq. Ft.
Size 5220
No. No. Dw.
Stories Units
New ❑ Add ❑
Alter ❑ Repair ❑
Demolition ❑
GAR 754'
FINAL DATE
INSPECTOR
wail 14-14
Date 1011.2/Permit
y
PE341. ' Soa
an" d fouhCain '.not ' a
part Of
this permit.
Estimated Valuation
S-165.717
PERMIT --
AMOUNT
•Plan Chk. Dep.
1250. 0a
Plan Chk. Bal..
,S
644-51 ,
Const.
1098.00
Mech.
93.00
Electrical
185.75
Plumbing
15.8.00
S.M.I.
25.53
Grading
20.00
Driveway Enc.
Infrastructure
2000.00
TOTAL
SA e 475. 135
REMARKS
: i f i #W-
LA UU114TA
:~7 t'rvrYy: JUU
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 1011.2/Permit
Validated by:
Validation.
CONSTRUCTION ESTIMATE
IST FL. SQ. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SQ. FT. ®
CAR P. SQ. FT. p
.WALL SO. FT. ®
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION $
NO. ELECTRICAL FEES
UNITS
MOBILEHOME SVC.
POWER OUTLET
NO. PLUMBING FEESi
s�
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
COLL. AREA
FLOOR DRAIN
ROUGH PLUMB.0`
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
FORMS
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
ROCK STORAGE
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
HEATING (FINAL)
FURNACE UNIT WALL FLOOR SUSPENDED
KEINF. STEEL/ —�G—
LAUNDRY TRAY
TEMP. POLE Z5/ y/
AIR HANDLING UNIT CFM
KITCHEN SINK
WATER HEATER
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET'
BOND BEAM
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
_$
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
FINAL INSP.
BOILER B.T.U.
SO. FT. ®c
BATH TUB
VENTILATION
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
FIREPLACE
SO.FT.GAR ® 3/ac
HOUSE SEWER
SPARK ARRESTOR
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
YI&THING6,2q-,�
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
40ETBACK/2—_r0— a
ROUND PLUM
UNDERGROUND UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.0`
1 `/ ,d
�d�ONDING l Si —9lJt
u ,
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
9- OUND. REINF/2 3G— Y
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
KEINF. STEEL/ —�G—
GAS (FINAL)
TEMP. POLE Z5/ y/
-.
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
FINAL INSP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FRAMING
FINAL INSP.
ROOFING
r
4,/y /`��. •2 �� T ��L
.
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
YI&THING6,2q-,�
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
GARDEN WALL FINAL
12/30/86
COACHELLA VALLEY UNIFIED Smom DISTRICT
CERTIFICATE OF CXCMPLIANCE
(Government Code §53080)
Project Name: PGA WEST----------------------------------------------
Project Address: 55605 Pebble Beach, La Quinta C -
Project Owners Name:M/Mrs. Arthur Brant Phone No.: - -454-7861
Project Description: 5200 square foot residence
Building Type (circle one) Residential (Include No. Dwellinq Units)
Commercial Industrial
Tract No. Lot No.
(If Tract attach Schedule "A" of all lots by tract, square footage for
each lot and total.)
Assessor's Parcel No.
(If Schedule "A" is used.show Assessor's Parcel No. for each lot if one
exists or Assessor's Parcel No. for parcels before sub -divided.)
Total square feet of Building Area: 5200
Certification of Applicant/Owner. The person signing certifies that
the above information is correct and makes this statement under penalty
of perjury and further represents that he/she is authorized -o sign on.
behalf of the owner/developer.
Dated: Signature:
City/County Certification:
(signature}- OPTIONAL
(title)
(to be completed by school district)
School district requirements for the above project have been or will be
satisfied in accordance with one of the following (circle one):
Gov. code Gov. Code Agreement existing Not sulDject to
53080 65970 prior to 1/1/87 fee re.1irements
(AB 2926) (SB 201)
5200 SUBJECT TO FEES 'IN EFFECT PRIOR T0.
Total number of sq. ft. LEGISLATION
Amount per sq. ft. $ ;;
Amount collected $
Assistant Superintendent
School District OfficialAadla k4,4n�=�- Title Business- Services':=...
Phone No. 619 = 399 - 5137 'Date PYovember 13, 1987•..:
Note: AB 2926 and SB 201 fees are capped at $1.50 per square foot for
residential construction. AB 2926 is capped at $0.25 per square
foot for carmercial and industrial projects.
Jaz;