00250 (SATT)Ads
Address
%'155 Pebble�t
s
Owner
Mailing
Address
City T792260
Tel.
Palm �-
Contractor
ress
i 4
ty/ QUU J
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
No.
002250
WING: TYPE CONST. OCC: GRP.
Number
al Description
ect.Description PGA k MT WAN 40 M
ep
City _ . - ..
Zip
Tel..
BMW
State Lic.
City
BM 3142
& Classif. • 88130
Lie. # 328
Sq. Ft. � s No. No. Dw.
3 Z
Size'Stories Units
Designer
New ❑X 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 Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
i..
effect. \ ,' i . . . j .
.
SIGNATURE DATE
1f OWNER -BUILDER DECLARATION y
Valuation
I hereby affirmEstimated
that I am exempt from the Contractors License Law for the following
$:197,349.00
reason: (Sec. 7031. S,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
r- - -
requires the applicant for such permit to me 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
-
Dlvlsion 3of*the Business and Professions Code, of that. he'is exempt therefrom, and the basis
for the Any Section 7031.5 for
Plan, Chk. Dep. -
alleged exemption. violation of by any applicant a permit
" subjects the applicant to a civil penalty of not more'thanfive hundred dollars ($500).
Plan. Chk. Bal. X4.19
0 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
Const. ��
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,A
r
Mech. - 5.Rfs3cd
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
Electrical
of proving that, he did not build or improve for the purpose of sale.)
O 1, as owner of the property, am exclusively contracting with licensed contractors to con-
Plumbing
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. - - Z. .
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
_
Grading
❑ I am exempt under Sec. B. 8 P.C. for this reason
Driveway Enc.
Date Owner
Infrastructure 2w00e410
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
0.Copy is filed with the city. ❑ Certified copy is hereby furnished.'
TOTAL
_
CERTIFICATE OF EXEMPTION FROM
REMARKS
C� WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less.)
.
I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the Workers' Compensation
Laws of California.
`
'DateOwner
NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become
-'
ZONE: BY:
subject to the Workers' Compensation provisions of- the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
MinimumSetback Distances:
Front Setback from Center. Line
.
Rear Setback from Rear Prop. Line
CONSTRUCTION LENDING AGENCYSide
Street Setback from Center Line
I hereby affirm that there is a construction lending agency for the performance of the
-
work for which this permit is issued. (Sec. 3097, Civil code.)
Side Setback from Property Line
Lender's Name
Lender's Address
FINAL DATE INSPECTOR
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have
>$"'g
read this application and state that .the above information is correct.
Issued by: Date Permit
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 rte•
Validated by:
� r� zr {e r
Signature of applicant— % Date
Mailing Address ' r tt ,+ # '
Validation:
City, State, Zip t t
A5114 4 8. 3580.17 CK
_ ..
HARD COPY
_ .
CONSTRUCTION ESTIMATE '
NO. ELECTRICAL FEE.
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. 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.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APP.IEQUIP.
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.
SQ. FT. ®c
BATH TUB
INAL INSP. z^t
d
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® 3/ac
HOUSE SEWER
GAS PIPING
PERMIT FEE
PERMIT FEE
PERMIT FEE
DBL
TOTAL FEES
MICRO FEE MECH.FEE
PL.CK.FEE
CONST. FEE ELECT. FEESMI
FEE PLUMB. FEE
STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBING a
UNDERGROUND
Gi UNIT /
COLL. AREA
VV -T SLAB GRADE' D
OUGH PLUMB. _411?
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
EWER OR SE ICi N
OUGH WIRING G
19 s
DUCT WORK
ROCK STORAGE
&J"FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL ,
AS (FINAL) �1 /
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
INAL INSP. z^t
d
V(.eFRAMING !
AF
INAL INSP.J� ,/� L
JNA
&ZROOFINGOrG/ n r�
VENTILATION O•
Q R`/ w``� `C7 I `
'0' 7Uf L�
J o
REMARKS:
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