002225 (SATT)44
P.O. BOX 1504 No, 002225
Building 78-105 CALLE ESTADO
Address 80-'483 Pebble B.NaCh LA QUINTA, CALIFORNIA 92253
Owner
Mailing
im �V BUILDING: TYPE CONST. OCC: GRP.
Address 75--W5 5 � Y?jra A.P. Number
City. Zip Tel.
Poll . 9226th $a s Legal Description
Contractor Project Description VGAkM .40 OR
&ti M=fg and i
Address - .. .. `"
City_dZM Zip Tel.
State Lic. City + 3142
& Classif. 2$8 38 Lic. # 3 Sq. Ft. GM . - No. No. Dw.
Arch:, Engr.,
Size Stories Units
Designer New 0 Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
CityZip State
F. Lic. # _ ..
LICENSED CONTRACTOR'S DECLARATION
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. `�4 <
t• _
SIGNATURE, DATE _
OWNER -BUILDER DECLARATION
Y affirm that I am exp 9 Estimated Valuation
I hereb9%j3At3o4C!
eq ' a
reason: (Sec. 7031.5,Business anndd t from the Contractor's License Law for the in Professions Code: Any city or county which requires •a. -
permit to construct, alter, impiove, 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 AMOUNT
3 of the Business and Professions' Code, or that. he is exempt therefrom, and th'e basis-
for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. * Dep.. -
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 Plan Chk. Bal. 564.19
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and ec�7AD Ap^/�
Professions Code: The .Contractor's License Law does not apply' to an owner of property who Const. 1678.00
builds or improves thereon and who does such work himself or through his own employees, Mech. - - -5 1.5wA
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.) . - -E•.•- -
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing. �Q•��
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. 3-1. R3
such projects with contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. 8 P.C. for this reason Grading
Driveway Enc.
Date Owner Infrastructure 2.008.00
WORKERS' COMPENSATION DECLARATION
Ihereby affirm that I'have a certificate of consent to self -insure, oe 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. Q Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one 'hundred dollars (8100) 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.
Date Owner
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. 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 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. y e
I certify that I have read this application and state that the above information is correct. Issued by:- Date - -96 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 inspectio-n purposes. r, Validated by:
/
Signature of applicant * ! 1'J-%, _ Date r
Mailing Address %L 1 Validation:
City, State, Zip i t'•
j A 5 1 4 8 358u17. CK
HARD COPY /
T .f
CONSTRUCTION ESTIMATE AWL
NO. ELECTRICAL FEI
NO. PLUMBING FEES
1ST FL. SQ. FT. @ $
2ND FL. SQ. FT.
POR. SO. FT. @
GAR. SO, 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 BOONDING _
FLOOR DRAIN
MECHANICAL FEES
L/ORMS �
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASH ER(AUTO)(DISH)
APPLIANCE DRYER
GAS (ROUGH)
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
OTHER APPJEOUIP.
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
SQ. FT. @ c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR @ 3/ac
USE SEWER
REMARKS:
PIPING
PERMIT FEE
PERMIT FEE
EIPERMIT 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 MB "
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE ��� ���
2APUGH PLUMB.'
BONDING BOONDING _
HEATING (ROUGH)
STORAGE TANK
L/ORMS �
ER OR PIC
%LQQQGH WIRING 5/�
DUCT WORK
ROCKSTORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
`
REINF. STEEL 41-_ S'
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
&qb ,L INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus -x$-=$
LUMBER GR.
/ZANAL INSP. �i% �®
FRAMING �2�
IAL INSP. !�
ROOFING `� 20��
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING yP
MESH
ULATION/SOUND 1"
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
marc�.1 vn a alunw 1 vnc�lm 1 ww,
GARDEN WALL FINAL