002218 (SATT)P.O. BOX 1504 N o . 002218
Building$g4 78-105 CALLE ESTADO
Address Pebble LA QUINTA, CALIFORNIA 92253
Owner _
sawim ompmy BUILDING: TYPE CONST. " OCC: GRP.
Mailing
Address Driva A.P. Number
CityJZip Tel.
. 92260 �, Legal Description
Contractor _ Project Description PIMV� 10 Q
Natl. and TAnd Ram 6 B
.Address .
F
City Zip - Tela
»
State Lic. City
& Classif. 288130 Lic. # 328. Sq. Ft. DW 2272 No. No. Dw.
' Arch:, Engr.; •• -
Size Gait .592 Stories • 1 Units 1
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
effect. ) , ,. i
SIGNATUREDATE ..
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that I am exempt from the Contractor's. License Law for the following`��3
reason: (Sec. 7031.5,Business and Professions Code: Any city or .county which requires a 4 .5 l s
00
permit tostruct, alter, improve, demolish, or repair.any structure, prior to its issuance also r
requires the applicant for such permit to rile 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
Division 3 of the"Business and Professidns Code, or that. he is exempt therefrom, and the basis - -
for the alleged exemption. Anyviolation 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). or
O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bel. .89
do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. 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, Mech. - 5,,+i�
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 102.17
of proving that he did not build or improve for the purpose of sale.) - �� {�
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing - .:�b8.50
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. 9.84-
-such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
❑ I am exempt under Seca B. & P.C. for this reason
Driveway Enc
Date owner Infrastructure 2,000.00
WORKERS' COMPENSATION DECLARATION -
I hereby affirm that 1 have a certificate of consent to self -insure, ora 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.
TOTAL 3,303.90
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is -for one hundred dollars ($100) valuation
or less.) -
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.
'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 Minimum Setback DlStarlCE!S:
comply with such provisions or this permit shall be deemed revoked. '
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
This is a building permit when properly filled out, signed and validated, and is subject to FINAL DATE INSPECTOR
expiration if work thereunder is suspended for 180 days. 'tS�
I certify that I have 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.purposif
s.,, z r + f f Validated by:
Signature of applicants �� ig/.• �/11�r r� T Dater •� / "
_Mailing Address r S Validation:
City, State, Zip / v f
A 5 0 8 8 4 8 331,390 CK
HARD COPY
CONSTRUCTION ESTIMATE Adilk
NO. ELECTRICAL FE
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. 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
An"UGH
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING 6 B�j
n AL INSP. l� !i)
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
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
/2/gAB GRADES �Z
An"UGH
PLUMB. 86
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS fc®�
EWER ORLGH
WIRING R b
v
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEOUIP.
1AEINF. STEEL �Z
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
4NAL INSP.
w
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
n IAL INSP. �0 ��
FRAMING 6 B�j
n AL INSP. l� !i)
ROOFING(
2l/
VENTILATION
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING g
MESH
%f SULATION/SOUNDAV
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
P�yw?f-?i 2/fV14w vc-9