9549 (ELEC)T4hf 4 4 "
�j
P.O. BOX 1504 N 0 , arf� t 4 9
Building `��d's3 ? �"�-.,'3 �; `�-t 78-105 CALLE ESTADO
Address Sagebrush on nfashirigt;r n LA QUINTA, CALIFORNIA 92253
Ow
nty Of La Quinta
Mailing BUILDING: TYPE CONST. OCC. GRP.
Address P. 0. _ o-_ 1504
A.P. Number
City Zip Tel.
Lax Qtlinta 922)53 Legal Description
Contractor Project Description
J. iWfff Enterprise, Inc
Address
82 -_52 5i>~rra Ave.
City Zip Tel.:
indi ct 92201 347-9181_5
State Lic. City
& Classif. C 2 7 5 5 4 9 a 9 Lic. # rt 5 87 Sq. Ft. No. No. DW,
Arch„ Engr., Size Stories Units
Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel. .NCIy' E Na Charge oxi Per -
City Zip State ea 'i tcti1 lmlprove*"Qe 't Project- — per
Lic. #
Steve Spe—e -
LICENSED CONTRACTOR'S DECLARATION
I harpb affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7 of Division of the Business and Professions Code, and my license is in run force and
erf t;
SIGNATURE DATE
OWNER -BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractors License Law for the following
reason: (Sec. 7031.5,Businass and Professions Code_ Any city or county which requires a
permk fb construct, after, improve, damoitsh, or repair any structure, prior fo its fssuance also
requires the applicant tar such permit to RIe a signed statement that he is +tensed pursuant to PERMIT AMOUNT
the provisions of the Contractor's License Lew, Crispier 9 (commencing with Sec Bon 7000) of
Division 3 of the Business and Proresslcns Code, or thal. he is exempt therefrom, and the basis
ror the alleged exemption. Any violation of section 7031.5 by any applfcanf for a permif Plan Chk. Dep.
subjects the applicant to a civil penally of not more fhan five hundred dollars (5500). Plan Chk. Bal.
I, as owner of the property, or my employees with wages as their so16 Compensation, will
do the wont, and the structure is not Intended or offered for sale. (Sec. 7044, Bussness and COr1St.
Professions Coda: The Cdnfraclor's f icense Law does rwf apply to an owner of properly who
builds or kninfoves thereon and who does such work himself ar through his own emproyees. Mech.
provided that such irnprovernants are not intended or offered for safe. It, however, the building
of improvemenl is sold wfthfn 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.) ,
❑ 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_
such projects with a contraclor(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
Ihereby affirm that I have a certificate of consent to self -insure, or a certificate of
Worker's Compensation Insurance, or a oer.Mled copy thereof. (Sec. 3800, Labor Code.)
Polo No. rp-y —
Copy is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS' COMPENSATION INSURANCE
(Tills section need not be completed if the permit is for one hundred dollars (S100) valuation
or less.)
1 certify that In the performance of the work for which this permit is issued, I shall not
employ any parson in any manner so as to become subject to the Workers' Compensation
Laws of California
Date--------- Dwner
NOTICE TO APPLICANT: If, affor making this Certificate of Fxempybs you should become ZONE: BY:
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this pam+kshall be? daemed 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
Lenders 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 Permit
I agree to comply with all City and county ordinances and state taws relating to building
construction, and hereby authorize representatives -of this city to enter the above-.
mentioned property for Inspectlon purposes. Validated by:
Signature of applicant —Dale—
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SQ. FT. ®
2ND FL. SQ. FT. ®
POR. SQ. FT.
GAR. SQ. FT. ®
CARP. SQ. FT. ®
WALL SO. FT.
SO. FT.
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
YARD SPKLR SYSTEM
MOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
$
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
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.
SQ. FT. ® o
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1 Vi c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/Ac
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
SETBACK
GROUND PLUMBING
UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING
DUCT WORK
ROCK STORAGE
FOUND. REINF
GAS (ROUGH)
METER LOOP
HEATING (FINAL)
OTHER APP.IEQUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
=$
LUMBER GR.
[�
FINAL INSP. 5 / ( C�
l
FRAMING
FINAL INSP.
ROOFING
Y�
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
I NSU LATIONISOUN D
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SiGNATURESIINITIALS
GARDEN WALL FINAL