PGA West Phase 15A (SFD)Qumr f
ce 4�t 4 �p I /�
P.O. BOX 1504 No.
Buildingf} T � I'�rbfADO
Qo- vm
Address LAUINTA,
CALIFORNIA 92253
Owner
Mailing
BUILDING: TYPE CONST. OCC- GRP-
Address 75—sof)5 C;
CityZip Tel.
1226C
Contractor
Address
Zip -Tel.
State Lic. City
& Classif. Lic. # _; 1
Arch., Engr., --
Designer
Address Tel.
CityI Zip State
J 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.
$IGIJ ATIIRE _ :PATE
OWNER -BUILDER DECLARATION
I hereby affirm 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 of Section 7031.5 by any applicant for a permit
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
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
builds or improves thereon and who does such work himself or through his awn employees,
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.)
❑ 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 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.)
❑ I am exempt under Sec. B. & P.C. for this reason
Date Owner
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. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.)
I certlfy 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: Y, ager malting this .Cerllficate pt Exemption you should become
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions of this permit shall he deemed revoked.
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.)
Lender's Name
Lender's Address
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 Ihls application and state that the above information Is correct.
I agree to comply with all city and county ordinances and state laws relating to building
onnstructlon, and hereby authorize representatives sof this city to enter the above-
mentioned property for inspection purposes.
Signature of applicant- Date
Mailing Addre
City, State, Zip
A. P. Number
Legal Description
Project Description
Sq. Ft. L4 :
Size
No. No. Dw.
Stories Units
New Q Add ❑
Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation
PERMIT
AMOUNT
Plan Chk. DQp.
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing
S.M.I.
Grading
Driveway Enc.
Infrastructure
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by: _ nate Permit
Validated by:
Validation:
_J A7285 2 li) iI�i.[1
HARD COPY
CONSTRUCTION ESTIMATE
;ROUND PLUM BINGJ J-.�
NO. ELECTRICAL FE'
NO. PLUMBING FEES
1ST FL. SQ. FT. ®
2ND FL. SQ. FT.
POR. SQ. FT. @
GAR. SQ. FT. ®
CAR P. SO. FT. ®
WALL SO. FT.
SQ. FT.
ESTIMATED CONSTRUCTION VALUATION
COLL, AREA
UNITS
L ROUGH PLUMBS _13��
BONDING
YARD SPKLR SYSTEM
STORAGE TANK
MOBILEHOME
POWER OUTLET
BAR SINK
AUX", �?A!NS
-
DRAINAGE PIPING
&&OUGH WIRING s `�
DUCT WORK
ROCK STORAGE
DRINKING FOUNTAIN
GAS (ROUGH);
METER LOOP
URINAL
$
OTHER APP.IEQUIP.
WATER PIPING
NOTE: Not to be used as property tax valuation
TEMP. POLE
FLOOR DRAIN
MECHANICAL FEES
GROUT
WATER HEATER
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
-$
LUMBER GR.
RAMING S~ i y
ROOFING
..�C
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
FIREPLACE
SPARK ARRESTOR
LAUNDRY TRAY
AIR HANDLING UNIT CFM
MESH
" INSULATIONISOUNDL
FINISH GRADING
KITCHEN SINK
ABSORPTION SYSTEM B.T.U.
FENCE FINAL
INSPECTOR'S 51GNATURESlINI7fAL5
TEMP USE PERMIT SVC
WATER CLOSET
COMPRESSOR HP
GARDEN WALL FINAL
POLE, TEMIPERM
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.
SQ. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/sc
HOUSE SEWER
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
1SETBACK f 7
;ROUND PLUM BINGJ J-.�
UNDERGROUND
A.C. UNIT
COLL, AREA
�41-1 SLAB GRADE
L ROUGH PLUMBS _13��
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
eSEVVER OR S5 1p,
&&OUGH WIRING s `�
DUCT WORK
ROCK STORAGE
nCFOUND. REINF.3—/ 3-- 7'j 14
``
GAS (ROUGH);
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
%9 FINALINSP.
BOND BEAM
WATER SYSTEM
Apt, INAL INSP.?-�_ b
'� INAL INSP. $
U/�
09%/ wAG( AIA f L
GRADING
Cu. yd.
plus x$
REMARKS:
-$
LUMBER GR.
RAMING S~ i y
ROOFING
..�C
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
THING
MESH
" INSULATIONISOUNDL
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S 51GNATURESlINI7fAL5
GARDEN WALL FINAL