002451 (RPL)P.O. BOX 1504 No, 002451
Building 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
Owner
Mailing
BUILDING: TYPE CONST. OCC. GRP.
Address g.0. BM 1659 A.P. Number 774.033-001 and 002
CityZip Tel.
Ila . 92M Legal Description
Contractor Project Description
F Fx P' pCTL3u
Address
53=045 AVMijda H=mkbs
City Zip Tel.
Ila Quint a 92253 564-5070
State Lic. City
& Classif. 4344 Lic. # 130 Sq. Ft. TIM 392 No. No. Dw.
Arch., Engr.;
Size 44M - d, - Stories Units
Designer New EIX 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 -.BBussiness and Professions Code, /and my license is in full force and
effect. V
SIGNATURE -'�k DATE
t OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation /. 1► �Ifya�yyn� n�A/�
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a S 14w/SS3'll.W
permit to construct, -alter, improve, demolish, cr 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
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 Plan Chk. Dep. '
subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal.
❑ 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 Const.
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.
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 7
of proving that he did not build or improve for the purpose of sale.) .. �1
❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing
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, %n
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
Grading
❑ I am exempt under Sec. B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure
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
❑ Copy is filed with the city. . O Certified copy is hereby furnished.
TOTAL t a14 ^ AA
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 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.
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 Minimum Setback Distances:
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 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.
I certify that I have read this application and state that the above information is correct. Issued by: Date %,riw t; Permit
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives sof this city to enter the above-
mentioned property for inspection prJrposes. ^ i; Validated by:
Signature of applicant+.? ? I I .t_s �✓ ;tT J 4. Date
Mailing Address.,yA.,.-�y,r.. ' T-� Validation:
City, State, Zip
A 5 9 2 5 7 7 1.93.46 CK
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING TEES
1ST FL. SO. FT. ® $
2ND FL. SO. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. I S0. 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
PLUMB.
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
GAS (ROUGH) Q /
f /
LAUNDRYTRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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
BOND BEAM
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1114 c
SEWAGE DISPOSAL
LUMBER GR.
SO.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
GAS PIPING
PERMIT FEE
�f
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
GRD PL
�5
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADEROUGH
PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF.
GAS (ROUGH) Q /
f /
METER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
44 AS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ -Plus-X$-=$
LUMBER GR.
A% FI AL INSP. �(d
J
FRAMING
FINAL INSP.
ROOFING
�CT Z
�f
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
GFINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURES11NITIALS
GARDEN WALL FINAL