12501 (STOB)• "
yl 4 4 P.O. BOX 1504 N o . 12501
Building 49--499 Eisenhower 78-105 CALLE ESTADO
Address LA QUINTA, CALIFORNIA 92253
"Landmark nand Co.
BUILDING: TYPE CONST. OCC. GRP.
A.P. Number
Mailing
Address P.O. Pox 1000
City
Zip
Tel.
La Quinta, CA
92253
l 564—'4111
Legal Description
Project Description Grand stands for Lexus
Dunes driving range December 1.0 _ 13, 1393
Contractor
& Rusae#.3 inc,
AddressRussell
3226 E. Washinatcin
cilos Angeles,
A 90023
l.
(213) 262-1161
State Lic
City
& Classi'. $ 149837
Lic. # 112
Sq. Ft. No. No. Dw.
Size Stories Units
Arch., Ergr.,
Designer
New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address
Tel.
City
Zip
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
J hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
000) of D-vision 3 of the Business and Professions Code, and my license is in full force and
e_ftect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sa-. 7031.5,Business and Professions Code: Any city or county which requires a
permit to thconstruct, 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 provisioxs of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 o. 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).
O I, as owner of the property, or my employees with wages as their sole compensation, will
do the worl, and the structure is not intended or offered for sale. (Sec. 7044, Bussness and
Professions Code: The Contractor's License Law does not apply to an owner of property who
builds or irrDroves thereon and who does such work himself or through his own employees,
provided the 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.)
Estimated Valuation ! �Q}�
PERMIT
AMOUNT
Plan Chk. Dep.
Plan Chk. Bal.
COnSt.
V . �Jv
Mech.
Electrical
Plumbing
❑ I, as ow ier 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 project with a contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. B. & P.C. for this reason
.S.M.I.
Grading
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 C: mp nsation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Polic No. Company
I dp"y is filed with the city. ❑ Certified copy is hereby furnished.
TOTAL
100.00
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 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
subject to the Workers' Compensation provisions or the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereb• affirm that there is a construction lending agency for the performance of the
work for whch 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 i0 work thereunder is suspended for 180 days.
I certify tEat I have read this 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
constructio-i, and hereby authorize representatives -of this city to enter the above -
mentioned property for inspection purposes.
Signature o applicant -Date-
Mailing AdC-ess
City, State, Zip
ZONE: BY: iI 1\1
Minimum Setback Distances: t
Front Setback from Center Lin
Rear Setback from Rear Prdp. Liz
Side Street Setback from Center
Side Setback from Property Line
FINAL DATE
INSPECTOR
Issued by: Date Permi
Validated by:
Validation:
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL. SO. FT. ®
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SQ. FT. ®
CAR P. SO. FT. ®
WALL SQ. FT.
SQ. 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
LAUNDRYTRAY
AIR HANDLING UNIT CFM
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
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID @ 1+/4 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 APPJEQUIP.
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.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
r�
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL