002198 (SATT)Building
Address
80-457 1,� Beach
Owner
Front Setback from Center Line
St=im
Mailing
DM 2596
Sq. Ft. 577
Size
Address
75-005 Country Clab
City
Zip
Address
Tel.
Contractor
Date 3-18-86Permit
City
Inatl M • and LM -A
Address
Validation:
•
4f
44
P.O. BOX 1504 N o . '
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Tel.
568-2828
002198
BUILDING: TYPE CONST: OCC. GRP.
A.P. Number
Legal Description
Project Description TIISAICTT, 9LAW 2 13
P3M 20
City
Sam
Zip
SMICIS
Tela
Sam
Front Setback from Center Line
State Lic.
& Classif. 29913Q
City
Lic. # 3203
DM 2596
Sq. Ft. 577
Size
No. 1 No. Dw. i
Stories Units -
Arch., Engr:,
Designer
New QC - Add ❑
Alter ❑. Repair ❑ Demolition.❑
Address
Tel.
Issued by:
Date 3-18-86Permit
City
Zip
State
Lic. #
Validation:
A4831
~
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) t. of Division 3 of the Business and Professions Code, and my license is in full force and '
, effec- ..
- -
SIGNATURE Y 17 - - -•' DATE
t j -OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt fiom the Contractor's License Law for the following
reason: (Sec. _7031.5, Business and Professions Code: Any city or county which requires 'a
permiNto 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).
❑ 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.) ..
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-
struct the project. (Sec. 7044, Business and Professions Coder 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. & P.C. for this reason
Estimated Valuation
'
t
PERMIT `'
AMOUNT
--r
-
Plan Chk. Dep.
-
Plan Chk. Bal.
195.15
.0011St.
S.�jGi Q
Mech.55.00
/;
55 • td0
' Electrical
�t�
U3.156
Plumbing
332.50
S.M.I.-,.
Grading
Driveway Enc.
Date Owner
Infrastructure
2,r(}00M
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
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 it 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 anyperson in any manner so as to become subject to the Workers' Compensation
Laws of Cali ornia.
Date Owner
NOTICE TO APPLICANT., If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation provisions or 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 %+ t
Mailing Address 1 y
City, State, Zip
HARD COPY
TOTAL 3,394.95
REMARKS
FOM M SPA Wr PXW OF ".fffS PITOWe
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 DATEINSPECTOR
Issued by:
Date 3-18-86Permit
Validated by:
Validation:
A4831
3 18 3394,95 Ck
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FE ' `
NO. PLUMBING FEES
IST 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.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, 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.
SQ. 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
NGROUND PLUMBIN2Wil
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE'''
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEP
ROUGH WIRING,
DUCT WORK
ROCK STORAGE
j FOUND. REINF. L
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.
(4&AL INSP. /�i►'—�(j
(
t(,,4 -'FRAMING Z ,,�
CeFINAL INSP./ Iv —�
ROOFING •
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND 7 5: `
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
norc�. � vn a awnh � vnc�m� � iww,
GARDEN WALL FINAL
9"'1 oq wr,K. 8fX11