002199 (SATT)Building 80—"rSPebble Beadh
Address
Owner
Mailing
Address 75-005
ClUb
City Izip
#4 ,
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Peam DesWt 92268 568--2828 '
Contractor
Address
No. 002199
BUILDING: TYPE CONST. . OCC: GRP. -
A.P. Number
Legal Description
Project Description PM REST WAM 2 B
PIM 28
City -
zip
Tela
State Lic.
City
MG 25961
& Classif. 2RA130
Lic. # 328
Sq. Ft. 517
Size
No. No. Dw.
Stories -Units -
Arch., Engr.,
Designer
New M Add ❑
Alter ❑ Repair ❑ Demolition ❑.
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION . .
1 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.' t f. f
SIGNATURE 1- - - - -- DATE
OWNER -BUILDER DECLARATION
I herebiaffirm 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
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
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 o/ Section 7031.5 by 'any applicant for a permit
subjects the applicant to a civil penalty o/ 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
Estimated Valuation
161 730.00'
t)
'- - PERMIT -
- -
Plan Chk. Dep..
_
Plan Chk. Bal.
495.15
Const.
w
Mech.
- !fi0 -
55 . €
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. I/, ,however, the building
or improvement is sold within one year o/ completion, the owner -builder will have the burden
o/ proving that he did not build or improve for the purpose of sale.)
Electrical
fl�
Plumbing
1 Js
O 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 o/ property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
0 I am exempt under -Sec. B. & P.C. for this reason
_.
S. M.I.i
`�' ,� 9
Grading
Driveway Enc.
Date Owner
Infrastructure
2x000.00
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have' certificate of consent to self -insure, or a certificate of
Workea r's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city.. . O Certified copy is hereby furnished.
TOTAL
_
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.
REMARKS
�yp
POM M SPA 1stiA PAM yu: '=S M,KM
' Date Owner
NOTICE TO APPLICANT: If, alter making this Certificate o/ Exemption you 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.
ZONE: BY:
-Minimum Setback Distances: - -
Front Setback from Center Line
Rear Setback from Rear Prop. Line
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.)
Side Street Setback from Center Line
Side Setback from Property Liffe -
Lender's Name
FINAL DATE
INSPECTOR
Lenders 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.
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. -
t
Signature of applican !� :�1r -- Date r 7/ (�
Mailing,Address d
Issued by:
Validated by:
Validation:
A 4 8 3 0
Date Permit
3 18 3394,55 C6
City, State, Zip
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FE
NO. PLUMBING FEES
1ST FL. SQ. FT. ® $IMF
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
I 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./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
FINAL INSP.
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
VENTILATION
GAS PIPING
PERMIT FEE
FIRE ZONE ROOFING
PERMIT FEE
I 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 PLUMBINGt/0,UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE '7
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SE!jCjr6
UdOUGH WIRING -7 fv
J io
DUCT WORK
ROCK STORAGE
FOUND. REINF. /� 3
/ o
GAS (ROUGH)
METER LOOP
HEATING (FINAL)19
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.
Zte—'FRAMING S. -
v
,,rFINAL INSP. O/) ,�/
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
(4CNSULATION/SOUND 7,3/, �y
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES/INITIALS
GARDEN WALL FINAL
f)`}i o¢•( 61Au. ('i/1, 8-4