003334 (RC)P.O. BOX 1504
Building 78-105 CALLE ESTADO
Address 1A QUV=iA COUMY CLUB LA QUINTA, CALIFORNIA 92253
No. Q0,3334
Owner
LA QUTi A CCWMY CLUB
BUILDING: TYPE CON$T.
OCC: GRP.
Mailing
Address
.
A.P. Number
CityJ
Zip
Tel.
Legal. Description
Contractor
Project Description
RMODEL WIMTM. AND, i}MNG AUA
'RICK J"=SON +Lr' UMUCTION
.. Address
P.O. BDX 2288
City
Zip
Tel. .
Iti
9.2202
564-2229
State Lic.
City
& Classif,' 397169
Lic. # 202
Sq.-Ft.
No. No. Dw.
Size
Stories Units
Arch., Engr.,
Designer
New ❑ Add IX 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 Business and/Prof ssions Code, and my license is in full
-force and
effect�nl'3 .� j f, F ! .. �7
y t !fir i..' �P r
SIGNATURE Y - DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
' I hereby affirm that I am exempt from the Contractor's License Law for the following
U UQO .
. 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
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 isexempt therefrom, -and the, basis
for the Any -Section 7031.5 by 'any for
Plan Chk. Dep.
-
-
alleged exemption. violation of applicant .a permit.
subjects the applicant to'a civil penally of not more than five hundred dollars ($500):-
Plan Chk. Bal..
_
157.62
,• 0•1, 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, Bussness and
Professions
Const. -
-
3�j� *�(}
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
°��
20.00
of proving that he di'd.not build or. improve for the purpose of sale.)
a
❑ I, as owner -of the property, am exclusively contracting with licensed contractors to con-
Plumbing
40.00
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.L.
such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) -
Grading
❑ I am exempt under-Sec.B. 1i. P.C. for this reason
Driveway Enc.
s
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.. ❑ Certified copy is hereby furnished.
TOTAL
460.12
CERTIFICATE OF EXEMPTION FROM
REMARKS
_ r WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit is for one hundred dollars ($100) valuation
or less.)
I certify 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,,
t t a Ali
ti ayf 41t`.1.:;��r
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
comply with such provisions or this permit shall be deemed revoked.
_Minimum Setback Distances:
Front Setback.frorn 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 it work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information'is correct.
-I
Issued by:
/ 2�3>/9% Permit
Date 9/2
agree to comply with all'city and county ordinances and state laws relating to.building
• - -
construction, and hereby authorize representatives .of this city to enter the' above-.
mentioned property for inspection purposes.
Validated by:
Signature of applicant Date
Mailing Address
Validation:
City, State,.Zip
HARD COPY I ..
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBINQ FEFS-7 ,
1ST FL. SO. FT. ®
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT. ®
CAR P. SQ. 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
2
$
WATER PIPING
NOTE: Not to be used as property tax valuation
-.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.000L HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
a
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.
SO. FT.® c
BATH TUB
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 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 /��!i ELECTRICAL HEATING & AIR COND. SOLAR
SETBACK
ROUND PLUMBING
3/
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
LUMBER GR.
FINAL INSP.
. FRAMING �O� /
FINAL INSP.
ROOFING /0
6127
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
1
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH•
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL