15619 (DEMO)P.O. BOX 1504
No. 15619 E
Building 78-495 CALLE TAMPICO "
Address 77�7 0. Ave. 50 LA QUINTA, CALIFORNIA 92253
Owner
T;,a . Quinta Country Club
Mailing, . �; BUILDING: TYPECONST:- •'OCC:GRP:`—
Address Poll). .BOX 99
A.P. Number
City Zip Tel.
j 4:ci ���53 -�tl Legal Description
La sactm • �- De atclitimu of cart barn aod, :
: Contractor' - Project Description
RtEttf a31': oF3S r1?Gt3.oE1 .i5(mE:diatl c'JC dCEEEt structures
Addr(e(�'�ss '' �q -�
BO
City Zip Tel.`
Y®rba • a.3rada. 92686 (7I4)993-332t
State Lic City'
& Classif. , 3E3 :�,��. Lic. # Sq. Ft. t ; No No., Dw. '.
Arch.; EngrSize Stories Units
.,- - - -
Designer. New ❑ Add ❑ Alter ❑ Repair❑ Demolition li
Address Tel.
City JZip State A.
Lic: #
LICIENSED.CONTRACTOR'S DECLARATION ,a
I hereby affirip4hat vam licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of he usiness and Professions Code, and my license is -in full force and
jeffeof
-
T$IGNA7URE Y X'�ll�/ J .%WR iJ G✓ f DATE -
: 'oWNER-BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following j J`- i�r! 0" r `,
reason: (Sec. '703 1.5, Business and Professions Code: Any city or county which' requires, a, '•" -t,
permit to construct,. utter, improve, demolish, or repair any .structure, prior to, its, issuance also • _� -
requires the, applicant for such permit to Me 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 •• �,
Divlslon 3. of 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 applicantfor a. permit. Plan Chk.. Dep..
subjects the applicant to a civil penalty of not more than. five hundred dollars.($500): ;- -
. ❑ I, as owner, of the property, or my empioyees•with wages as their sole compensation, will. Plan Chk. Bal. -
do the work, and the structure is not intended or, offered for sale. (Sec. 7044, Bussness and CDnst.
Professions Code;-'The.Contractor's License Law _does not apply to an owner of property who -
builds or improvesthereon and who -does such work himself or through his own employees, Mech: •, ti '
provided that such�-lmprovements are not,lntended 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
-
of proving that he did. not. build or 6nprove for the purpose of sale.) '• -
b'I, as owner of the property, -am exclusively contracting with licensed contractors to con- - Plumbing i
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.contractor(a) #tensed pursuant to the Contractor's License Law.) -
❑ 1 am exempt under Sec - ` B. & P.C. for this reason Grading i
Driveway Enc.
Date owner Infrastructure i
u
em Y r1413 :. 00
WORKERS' COMPENSATION DECLARATION i11
I hereby affirm ttiat I have a certificate of consent to self insure, or a certificate of
Worker's Co pensatfon'Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
Eopy is filed with the city. ❑ Certified copy is hereby furnished.'
TOTAL45.00.
CERTIFICATE OF EXEMPTION FROM •. REMARKS
WORKERS' COMPENSATION INSURANCE "
(This section need -not -be completed U-the permit is. for one. hundred dollars ($100) valuation - - - -
. or less.) -
1,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: ff, 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 from -Center Line
RearSetback from Reg Prop. Line
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND • •-,Side,Stieet.Setback from Centerline '
SHALL SUBJECT ,AN EMPLOYER TO CRIMINAL PENALTIES' AND CIVIL FINES -UP .TO' ONE
:.HUNDRED THOUSAND DOLLARS ($100,D00), IN ADDITION TO THE COST OF COMPENSATION 1 �- �Slde Setback .from``Property,Llne
DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND U I t
ATTORNEYS FEES.. n I
This is a building permit when properly filled out, signed end.validated;-and is'subject to FINAL DATE j� I INSPECTOR
expiration it
work I ereunder is suspended forA80 days. I� , AVG 0.8. (}C;.� I� -
I certify that I have read this application and state that -the above information is correct. Issued l)y - h,f Date J.1.Permit
I.agree to comply with all city and county ordinances and state.laws relating to building J
construction, and hereby authorize representatives -of this 'city to enter the above
mentioned property for inspection purposes. Validated-by-
-7
Signature ofapplicani Date oy
Mailing' Address - VSlldatlOn:_ • ao"'�r /: M , -
City, 'State,'Zip
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBINGi FEES
v
AST FL. S0, FT. ®
2ND FL. SO. FT. p
FOR. SO. FT. ®
GAR.. SO. FT. ®
CAR P. S0. FT.
WALL S0. FT. ®
SO. FT. ®
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
r-
YARD SPKLR SYSTEM
^
MOBILEHOME SVC.
BAR SINK'4
i a
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.000L 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,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 ® 11/4 c
SEWAGE 'DISPOSAL'
SO.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
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.APPJEOUIP. '—
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.'
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$, Plus
x$ m -$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP.
ROOFING
REMARKS:
VENTILATION
'FIRE ZONE ROOFING
FIREPLACE
SPARK. ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATIONISOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
-
GARDEN WALL FINAL
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