003811 (SATT)• I, I
P.O. BOX 1504 No. 003811
Building 78-105 CALLE ESTADO
Address 56-086 Pebble Beach LA QUINTA, CALIFORNIA 92253
r.. .. ..
Owner
BUILDING-- TYPE CONST.
Mailing OCC: GRP.,
Address 75-060 Country 'Cltib Drive A.P. m
Nuber FGA West
City Zip Tel. _
Par ser .t 92260 - 568.2828 Legal Description
Contractor Project Description Phage* 29'3 Plan 100
?11** 3 A 1 s �►r' age Land
Address - _ a
Sar1e
City Zip Tel.
State Lic. City
& Classif. 288130 Lic. # 328 _ } Sq. Ft. bWG 2232 No. No._Dw.
Engr.;
Size ,�,�r �.�.� 'Stories Units
•Arch., _. _
Designer New ❑ Add ❑ ._ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
-Lic. #
LICENSED CONTRACTOR'S DECLARATION.
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Sectiorl
7000)of Division
,
3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
EStlmated Valuation
'
I hereby affirm that I am exempt from the Contractor's License Law for the following
�j
r 1aY G t C
8 646
reason: (Sec. 7031.5,Susiness and Professions Code: Any. city or county _which requires a
4�,7. �
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
PERMIT•
AMOUNT
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 Section 7031.5 by -any for, -
-
Plan Chk: Dep.. '
violation of applicant a permit
subjects the applicant to a civil penalty of not more than five hundred dollars'($ 500).
Plan Chk., Bal.
❑ I, as owner of the property, or my employees, with wages as their sole compensation, will
S 485.64
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and
Professions Code: The
.A
Const' -580.50
p �tq
Contractor's License Law does not apply to an owner of properly who
builds or improves thereon and who does such work himself or through his own employees,.
Mech.
• V
C t^1
. , provided that such improvements are not intended or offered for sale. If, -however, the'building
d[l
-57 • 0
or Improvement is sold within one year of completion, the owner -builder will have the burden
Electrical -
.fir
lift 1
of proving that he did not build or improve for the purpose of sale.).
A2 ..
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
J 7%
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,
such projects. with a contractor(s) licensed pursuant to the Contractor's License Law.)- -
Grading
O.1 am exempt under. Sec. B. & P.C. for this reason
Driveway Enc.
Date owner
Infrastructure
569 •*33
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.
CERTIFICATE OF EXEMPTION FROM
WORKERS'. COMPENSATION INSURANCE
(This section need not be completed if the permit Is for one hundred dollars ($100) valuation
or less.) - -
I certify that in the performance of thg work for which this permit is issued, I shall not
employ any person -in any manner so as to become subject to the Workers' Compensation
Laws of California.
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate of Exemptionyou should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the
work for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and'county ordinances and state laws relating to building
construction, and hereby authorize representatives -of this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
HARD COPY
TOTAL I tt4 _412_t' A A jJ<7i'7-YJ4
REMARKS
-
';�Ir axr�CF} ltt:ii{'tt•x �$Sr'.�i.'r4
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/7/88 Permit
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $
2ND FL. SQ. FT. ®
POR. SQ, FT, ®
GAR. SQ. 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
FORMS
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPIEQUIP.
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:
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 APPIEQUIP.
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
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL