14092 (SFD)TWY/ 4 4 QUM*
Building
Address `= '11 r' 4%c_o IL C3 -ri i
Owner
YrI L1. - 1!'tc S iC Ci? ltk n ,t i
P.O. BOX 1504
78-105 CALLE ESTADO
LA QUINTA, CALIFORNIA 92253
Mailing
Address '1515 50111-i I'D" rt2l'E't. Ste. 200
City Zip JTel.
Belrnardin , Ca 9240 ( 909 ) 3c"11 - 6 0 0 7
G4:',;t1r
Address
Zip ITel.
State Lic. City
& Classif. B 314473 Lic. #
Arch., Engr.,
Designer Prank k Gonzal 35 Assoc.
AY15s a gTel.
iro?
City . Zip State
C 9266E Lic.#
LICENSED CONTRACTOJrs DECLARATION
I hereby affirm that I am licensed under orovitions of Chapler'J (commencing with Section
7010, of Division 3 of the Business and Professions Go)$tr, and my license i5,in full forge and
I effect.
�1C t�ATI7FiE- � - _ SATE
OWNER-BUICOER DECLARATION
1 hereby affirm that 1 am exempt from the Conlractoi45 License Law for the following
reason; (Sec. 7031.5,0uslness and pfolesslon$ Code. Any city or county which requires a
Permit Io construct, ahar. improve, demolish, or repair any stnrcture, prior to Its issuance also
th
requires e applk:ant For such permit to (118 a signed statement rho[ he is aCensed pursuant 10
the pfcuislons of the Contractor's Llcensa Law, Chaprer 9 (commAncing wifii Section 7000) of
Oivislort 3 OF the Buainess and Profasaicns Cods, or that he is exempt lherafrern, and lho basis
for the allegad exemption. Any v DWkn o1 Section 7031.5 by any applicant for a permit
subjects 1h applicant to a etvl) penally of not more Ihan live hurndrad dollars rS500),
❑ f, as owner of the property, or my amp loyeas with wages as their sale comp en5at[on, will
do the work, and She structure Is not Intended or offered for saIa. fSec. 7044, Bursness and
Professlens Code' The Canrlaclor:s License Law does not apply to an owner at praperfy who
builds of Improves thereon and who dues such work himself or through his own emptoyeas,
provided lhaf such improvements arc not intended or offered tar sale. ff, however, the bulldfng
or Improvemenf fs sold within one year of completion, the ownerbuilder wltl 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 Arofesslons Code; The Contractar's Lkense Law
does not apply to an owner of properly who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ 1 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 cerflflcate 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 if the permit is for one hundred dollars ($100) valuation
or less.)
I certify that in the performance of thV work for which this permit is issued, I shall not
employ anypperson in any manner so as to become subject to the Workers' Compensation
Laws of California. _
Date Owner
N071cE Ta APPLICANt. if, after making this Cerrificale of ExamlJ?l n you should become
subject to the Workers' Compensation provisions of the Labor Cuda, you must forthwith
comply with such provisions or this permit shall be 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 this application and state that the above informatlon is correoi-
I agree to comply with all city and county ordinances and state laws relaiimg to building
canstruction, and hereby authorize representatives of this city to enter the above•
mentioned property for inspection purposes.
Signature of applicant Date
Mailing Addre
City, State, Zi
No. 14092
BUILDING: TYPE CONST. Vi OCC. GRP:
A.P. Number 'IA -IBI -035
Legal Description 1, -1 4 Tr �':-. .a 4 5 7 Pha? I
Project Description
SID Paan 3X
Fr11who Ocrti yra @ vw Qu nta Xarte
Sq. Ft. No. No. Dw.
Size :r 2 16 Stories Units
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Estimated Valuation f 3 2, -1 . v; 0
PERMIT AMOUNT
Plan Chk. Dep. 210. 9
Plan Chk. Bal.
37 50
Const.
755. (10
Mech.
01 j . y 0
Electrical
151 1 11
Plumbing
144.00
S.M.I.
Grading
20.00
Driveway Enc.
0 r
Infrastructure
„ CI . 54
TOTAL • ,r 7 7 8. 17
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
Issued
Validat
Validat
CONSTRUCTION ESTIMATE
PLUMBING
GROUND PLUMBING
ROUGH PLUMB.
SEWER
GAS (ROUGH)
GAS (FINAL) r
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL
2ND FL.
POR.
GAR.
CARP
WALL
ESTIMATED CONSTRUCTION
SQ. FT. .@ $
SQ. FT. Q
SQ. FT.
SQ. FT. ®
SQ. FT.
SQ. FT. @
SQ. FT. @
VALUATION $
WATER HEATER
WATER SYSTEM
UNITS
FINAL INSP.
GRADING
cu. yd.
$ plus x$
_$
YARD SPKLR SYSTEM
IMOBILEHOME SVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
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fry
GG
DRAINAGE PIPING
DRINKING FOUNTAIN
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FIRE ZONE ROOFING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SPARK ARRESTOR
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LA HING Z 4
LAUNDRYTRAY
AIR HANDLING UNIT CFM
ABSORPTION SYSTEM B.T.U.
COMPRESSOR HP
TEMP USE PERMIT SVC
POLE, TEMIPERM
KITCHEN SINK
WATER CLOSET
LAVATORY
HEATING SYSTEM FORCED GRAVITY
AMPERES SERV ENT
SHOWER
BOILER B.T.U.
SQ. FT. ® c
BATH TUB
CERT. OCC.
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
FENCE FINAL
SQ. FT. RESID @ 11/4 c
SEWAGE DISPOSAL
SQ.FT.GAR ® 3/,C
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
SETBACK
SLAB GRADE fC,
FORMS
FOUND. REINF.
REINF. STEEL
PLUMBING
GROUND PLUMBING
ROUGH PLUMB.
SEWER
GAS (ROUGH)
GAS (FINAL) r
ELECTRICAL
UNDERGROUND
BONDING
ROUGH WIRING
METER LOOP
TEMP. POLE
HEATING & AIR COND.
A.C. UNIT
HEATING (ROUGH)
DUCT WORK
HEATING (FINAL)
SOLAR
COLL. AREA
STORAGE TANK
ROCK STORAGE
OTHER APPJEQUIP.
GROUT
BOND BEAM
WATER HEATER
WATER SYSTEM
SERVICE
FINAL INSP.
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP. i
FRAMING
1
FINAL INSP.
ROOFING
VENTILATION
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fry
GG
f'
REMARKS:
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LA HING Z 4
MESH
INSULATIONISOUND
FINISH GRADING %
FINAL INSPECTION f fif T j J
CERT. OCC.
FENCE FINAL
INSPECTOR'S SI0NATURESA NVTIALS
GARDEN WALL FINAL