002217 (SATT)P.O. BOX 1504
Building7:78-105 CALLE ESTADO
Addres�� LA QUINTA, CALIFORNIA 92253
Owner _
'Mailing
Address �aClub Dr.
City Zip Tel.
9.
Contractor ��yy�ii}}�� �^y.� n Y .:
. :.ti.: tl. .:_Bf.L gage a Nes - 1 iod
Address
BUILDING:- TYPE CONST. -OCC:-GRP...,
A.P. Number
Legal Description
Project, Description SRI' m d3k
.. .. .. ,.... R. 6.F3 .. ..
City .. _
Zip.
Tel... _.
State Lic.
& Classif._',.288130
City
Lic. # 329. . •,
2272
No. s. -
Size • - - Stories Units - -- •- -
size . 2 StoNo.ries
Arch.- Engr..,. .
Designer.
New QKAdd ❑ 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'(comrrmencing with Section
7000) of Division 3 -of the Business and,Professions Code, and myaicense is in full.force and
- 1 . effect ; r
_
- .._ . .. ... .. .. - . ..
• SIGNATURE i s d✓ wd % -. -,r •. .. .`. -•-.. v - DATE
' c- - - / '}' /' - V ' OWNERJBUILDER DECLARATION
Irhereby affirm that I am exempt from the Contractor's License Law for the following
,. . reason: (Sec.. 7031,5,Business andzProfessions Code: --Any, pity or. county which requires -a •
permit. to construct; alter, improve, demolish, of 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 o/ the Contractor's''License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that. he is wiempt therefrom, and the basis .-
• for the* alleged exemptidn.,,,A°ny violation of Section 7031.5 by 'any applicant for a permit
EStlmated ValUatlOn
- - AMOUNT
PERMIT'•- ••-- ••- -
. �:.. - _ -
-
Plan Chk. bep.;;
• subjects the applicant to a civil penalty of not more than five hundred dollars ($500): .' • '•-
❑ 1; 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.ownerof property who
builds or improves thereon and who does such work himself or through his •own employees;MBC
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:), .; .
. - -
Plan Chk. Bal.._ 462.89
Const. `��. ' '
h. Vv
Electrical - - • �� '
�
,
Plumbing 32q.,So
- ❑ 1, 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 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.) •
,O 1 am exempt under Seca � - B; & P.C. for this. reason
_
S.M.I.-
Grading
_
Driveway Enc.
Date owner
Infrastructure 2e000.00
WORKERS' COMPENSATION DECLARATION
1. 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. ,0 Certified copy.is hereby furnished. " ...
TOTAL�.57
CERTIFICATE OF EXEMPTION FROM
_ . WORKERS' COMPENSATION INSURANCE: '- _
REMARKS
• (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.
- - 7 V,
Date_____!_- Owner
NOTICE TO APPLICANT: If, after making this Certificate of 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. (Seca 3097; Civil Code.)
-* • Side:Street Setback from Center Lirie
Side Setback from"Property Line
Lender's Name
FINAL DATE INSPECTOR
ssued•by:'' - Date" Permit - -
f
r
by:
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 stale that'the above information' is correct.
1' agree to comply *with all city and county ordinances and state, laws relating rto building ,'
construction, and hereby authorize�representatives of this city to enter the above-.
mentioned property for -inspection purposes: ItValidated
r
Signature of applicant / .fr+r �f�'•l -"" Date 7
Mailing Address {Y' fr.4,f"" " ""
Validation:
'A 5:0;8°9 :4- 18 1313,k,S�910 1
City, State, zip
HARD COPY]
CONSTRUCTION ESTIMATE Allikk
NO. ELECTRICAL Fmg1w,
NO. PLUMBING FEES
IST FL. SQ. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SQ, FT, ®
CAR P. SO. FT.
WALL SO. FT. ®
SO. 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
4, #FORMS /d�% F' �a y%i
v
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 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,TEMIPERM
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SO. FT. ® c
BATH TUB
SO. FT. ®c
IWATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.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
SETBACKGROUND
PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE �C/ /e4.
„ t&UGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
4, #FORMS /d�% F' �a y%i
v
ER OREP C T
UGH WIRING ',DUCT
l
WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
�/REINF. STEEL �y
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
/&NAL INSP.(`' ��
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
NAL INSP. n /O �
FRAMING V 24
ffzL INSP. (� �/
(/�
ROOFING �D
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING ® &j
MESH
�CISULATIONISOUND W7
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
1 UM"J biumA 1 UIItbllNl I IALb.
GARDEN WALL FINAL
(;)r? y W,01G�11yl�w,