003578 (RPL)y P.O. BOX 1504. N-0. - 00378
Building 78-105 CALLE ESTADO
Address 55—'4c'8J!5 Pebble Reach LA QUINTA, CALIFORNIA 92253
Owner
Ilk
` • rownf ield y
City .... _ ..-
Pa3,M Snrina_
Mailing
_ " `
BUILDING: TYPE CONST. • ' =
OCC: GRP.. '
Address
A.P. Number PM West
753360-012
City
New ❑ Add ❑
Zip12106-
el.
Tel.
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Zip
Legal Description
ZONE:
Contractor-
Caa fon- ar .Pools ,A' Spas
• " � "r �
Project Description �7��at^al.. �
~
S►a�
"
Address..
SIGNATURE '- -- DATE
Ilk
REMARKS
City .... _ ..-
Pa3,M Snrina_
Zip.
Tel..,
323--1303
(This section need not be completed if the permit is for'one hundred dollars ($100) valuation
-
_
State Lic.
&.Classif.
_
City
Lic. #
Sq. -Ft. -
Sze • _. _ .-
i
No. No. Dw.
,Stories Units. .
Arch.,-fngr., � _ _. ... .. , .
Designer
New ❑ Add ❑
'-
Alter ❑ •' Repair ❑. Demolition ❑
Address
Tel.
Xyr rrrzat3 Y ;�ir.tY X G;its
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City
Zip
State
Lic. #
ZONE:
'BYS•' '
'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:- -
'
•, LICENSED CONTRACTOR'S.DECLARATION - : , _• ' -
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division3-,of•the Business and.Professions Code; and my license is in full force and
effect. fir"•
"
Front Setback -from Center Line
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.$20,000
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 Contracfor'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 (5500).. • ' -' •
❑ 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 burdenEIBCtfICal
- of proving that he did not build, or improve for the purpose or 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. B. & P.C. for this reason
Estimated Valuation
.
-' . r.e.. - ••
...-PERMIT
-
- 'AMOUNT
- • •.r• ' -
.Plan Chk. Dep.•.
- •.
Plan Chk. Bal.
.. _ _. '
�, 5) .2 2
"'Const.'
'146 .5o
Mech.
f. is ii
:•FINAL DATE
1�
-
Plumbing -
Q.R
S.M.I.
' -
Grading
], . 44
Driveway Enc.
Issued by:
Date owner
Infrastructure
WORKERS' COMPENSATION DECLARATION
' 1 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 •
Q,fcopy is filed with the city.. , ❑ Certified copy is hereby furnished.
mentioned property for inspection purposes.
Validated by:
• Signature of applicant Date
- -
••
Mailing Address
-
TOTAL
,- City, State, Zip
CERTIFICATE OF EXEMPTION FROM
REMARKS
• 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, l shall riot
(]{}�i ) ?, AJIAJ__ (`)!,—•�7 - RJ_ w, f t7
,
• employ any person in any manner so as to become'subject to the Workers' Compensation
Laws of California.
Xyr rrrzat3 Y ;�ir.tY X G;its
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NOTICE TO APPLICANT If, after making this Certificate of Exemption you should become
ZONE:
'BYS•' '
'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. 3097, Civil Code.) - -
-
Side_ Setback from Property- Line -
Lender's Name
Lender's Address
:•FINAL DATE
INSPECTOR—
NSPECTOR,'
,*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 this
$ i t! A -
3 $
read application and state that the above information is correct:.
it agree to comply with all city and county ordinances and state laws' relating to building
Issued by:
Date •6 Permit
+
construction, and hereby authorize representatives -of this city to enter the -above•.: -
mentioned property for inspection purposes.
Validated by:
• Signature of applicant Date
Mailing Address
Validation:
,- City, State, Zip
_
7
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
IST FL. SO. FT. ® $
2ND FL. SO. FT. ®
POR. SO. FT. ®
GAR. SQ, FT. ®
CAR P. SQ. FT.
WALL SQ. FT. ®
SO. 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
QL�OUGH PLUMB./ -C
r�
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
L9&4AS (ROUGH) r �—
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
KITCHEN SINK
ABSORPTION SYSTEM. B.T.U.
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
POLE, TEM/PERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ®c
BATH TUB
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
1 z
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 PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
QL�OUGH PLUMB./ -C
r�
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
L9&4AS (ROUGH) r �—
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
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
FINAL INSP.
ROOFINGREMARKS:
� �
1 z
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
I NSrCG IV NO 01UNA 1 UMr01INI I IAW.
GARDEN WALL FINAL