10036 (RR)r et t Y,, - - 4,
P.O. BOX 1564 l t .. .•'
No. . 1003
Building 78-105 CALLE ESADO
Address 77-750 , AwiT?ue 50 LA QUINTA, CALIFORNIA 92253'
Owner t
La._ Quinta Country Club
Mailing BUILDING:' TYPE CONST. OCC: GRP.
Address Same
A.P. Number
City Zip Tel.
La.Quinta 92253 564-4151 Legal Description
Contractor o-ote Project Description.
SpraySystems
RE -ROOF
Address
City - - Zip
1000 Pillrjs 92276
State Lic..
& Classif'. . C3.9 306653
• -Arch.; Engr.,
Designer
Address
Tel.:
343--2022
City
Lic. # 104
Tel.
,City Zip State
r. Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7060) of Diwsion�3 of the la �Businessnd Professions Code, and my -license is inJulll force and
iect-
(SIGNATURE DATE '
5 ZOWNER-BUILDER DECLARATION "
I hereby affirm that] 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 or 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 apermit
subjects the applicant to acivil penally 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 work, andahe structureis 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. own employees,
,provided that such improvements.are-not intended or offered for,,sale. H,-however, the, building '-
.or improvement is soldwithin one. year or completion, the owner -builder, will have the burden
ofproving.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 Coder 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.)
❑ 1 am exempt under Sec. B. & P.C. for this reason
Date Owner.
WORKERS', COMPENSATION DECLARATION
I hereby affirm. that 1: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.) '
Polvy No. Company
9 Copy is filed with the city.. O Certified'copy is hereby furnished.' . +
n .. CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE'
(This section need not be completed ff�lhe permit Is for one -hundred dollars (8100) valuation
or less.) -
I certify that in the performance of.thq' 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 of the Labor Code,' you -must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
' I hereby affirmthat 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 information is correct.
I 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.
Signature of applicant Date
Mailing Address
City, State, Zip
Sq. Ft. .'No:: .
Size Stories.
New ❑ Add ❑. Alter ❑
No. Dw.
Units
Repair ❑ Demolition:•0
Estimated Valuation ' *'
73 600'
PERMIT AMOUNT,
Plan Chk. Dep.
Plan Chk. Bal.
Const., 522.50. '
Mech.
Electrical
Plumbing.
S.M.I.
Q
Grading
Driveway Enc.
Infrastructure
TOTAL
5d9, 9U
REMARKS' :
a+
rq 1
ZONE: - BY:'
Minimum Setback Distances:. r
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:. Date Permit -
Validated by:
-Validation:
CONSTRUCTION ESTIMATE
NO.
:ELECTRICAL FEES
NO.
PLUMBING FEES
1ST FL SQ. FT. ®
2ND FL SQ. FT.
POR. SQ. FT. ®
GAR.' SQ. FT. ®
CAR P. SO. FT.
.WALL ' SQ. 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
1,
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, TEM/PERM
LAVATORY'
HEATING.SYSTEM FORCED GRAVITY
AMPERES SERVENT
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
PLCK.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
a SLAB GRADE
ROUGH PLUMB.
BONDING
HEATING (ROUGH)
z STORAGE TANK
FORMS
SEWER OR SEPTIC TANK
ROUGH WIRING.
.DUCT WORK.
ROCK STORAGE 1
,FOUND. REINF.
GAS (ROUGH)
METER LOOP
HEATING (FINAL) .v _
'OTHER APPJEOUIP `�
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BONQBEAM
WATER SYSTEM
GRADING
CU. yd..
$;-Plusplus
x$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
z a,
C / %
L,r v� I.LU
U'l
D L l c � Lpl'
_1 �l
�p I r �A 1rn
REMARKS: "
VENTILATION
"FIRE ZONE ROOFING:
FIREPLACE-
SPARK ARRESTOR
y...
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH 'GRADING
FINAL INSPECTION
CERT., OCC.
FENCE -FINAL -
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL FINAL
"
m