003816 (SATT)44
P.O. BOX 1504 No. 0038,16
Building 78-105 CALLE ESTADO
Address 56-024 Pebble Beach LA QUINTA, CALIFORNIA 92253
Mailing
Address 75-005 Cot
City Zip
Palm Desert
Contractor
HatitQnal Ndxt-0,
Address .
Csx ne
City Zip
State Lic.
& Classif. 288130
Arch.; Engr., - -
Designer
Tel
Tel.'
City
Lic. #
BUILDING:. TYPE CONST. OCC: GRP.
A.P. Number PGA 7,110st
Legal Description
Project^ Description Pbase 29B PIan 20 M
328 .... Sq. Ft. DWG 2595 No.
Size f;77 Stories
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
No. Dw.
-Units.
Address
Tel.
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. '
City
Zip
State
Lic. #
Front Setback from Center Line
Rear Setback from Rear Prop. Line
_ LICENSED CONTRAOTOR'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.
Side Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the followings%
reason: (Sec. 7031.5,Susiness and Professions Code: Any city -of county which requires a
permit to construct, atter, 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 penally of not more than five hundred dollars ($500).
O 1, 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.) -
❑ 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 a exempt under Sec. B. t% P.C. for this reason
Side Setback from Property,Llne
Estimated Valuationy�
Bg
• - -
PERMIT
AMOUNT
-
Plan Chk. Dep..
INSPECTOR
Plan Chk. Bal.
525.10
COr1St.'�
{�
Mech.
��
Electrical
Q
�J�
i •
_
Plumbing
132.50
S.M.I. _
-_
- 22.57
Grading
Driveway Enc.
mentioned property for inspection purposes.
Date owner
Infrastructure
4,045.90
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.
Mailing Address
Validation:
- -
TOTAL $5.517-13
itt
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 tha 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.
D -
REMARKS
ate Owner
NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become
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. '
-ZONE:- _
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,Llne
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 4/7198 Permit
I agree to comply with all city and county ordinances and stafe 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
Mailing Address
Validation:
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
2ND FL. SO. FT. @
POR. SQ, FT, @
GAR. SQ. FT. @
CAR P. Q. 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
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP./EQUIP.
LAUNDRY TRAY
AIR HANDLING UNIT CFM
TEMP. POLE
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR @ 3/ac
HOUSE SEWER
REMARKS:
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP./EQUIP.
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.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
mbrec i vn a AwnA i vnewim I iAw,
GARDEN WALL FINAL