15814 (ELEC)�'.
414
P.O. BOX 1504 0 •-� 6d
Building 78-495 CALLE TAMPICO
Address 77'e750 90th -Avenue LA QUINTA, CALIFORNIA 92253
Owner
to d ai nta Countky Club Inc.,
Mailing BUILDING: TYPE CONST OCC. GRP.
Address same as above
A.P. Number
City Zip lTel:--'
La;-Qui-nta- 92253. Legal Description
Contractor-.. Project Description nsta1 near 2500 I=Pdeg; Gp
Address
City Zip' Tel.: k i
Yorba :%i.nda- 92686 - 714 93-3366
State Llc City ' : r
& Classrf o Lic. # Sq. Ft. `.No No.'Dw. x �r
x53t 3819 Size Stories Units
Arch., Engr:,
Designer.,., New ❑ Add ❑ Alter❑ Repair ❑ Demohtlon'O;
Address Tel.
7City. Zip , State 1
:•y Lic.'#
LICyENSED CONTRACTOR'S DECLARATION
I here yy ��fhrm�thalol am censed under,provisions of Chapter 9 (commencing with Section '
7000rof•DivlSfion of t eleu in and P fessions Code, and my licens is injull force and ,w
eff rCam'.' ] .'
GNATU ! DATE• .. - •. -
'` OWNER
-BUILDER Estimated Valuation p
;-hereby affirm that I am exempt from the Contractors License Law for the following Q V 'i�f t
reason:- (Sec. -7031.5,Business and Professions Code: Any ,city, or county which requires a
permit toconstruct,, after, improve, demolish, or repair any -structure, prior toits issuance also -
' •requires. the applccarit 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
-.
Divisioo3 of the Business and -Professions Code• or that.he is exempt therefrom; and the basis plan Chk. Dep.t -' •' for the alleged exemptkm. Any, violation of Section 7031.5 •by 'any applicant for. a permit -
sutijects.the applicant to a cM penalty of not more than rove hundred dollars ($500). Plan Chk. Bal.
❑ 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, Buisness and Const.
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, ' 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'
of proving that he did not build or smprove for the purpose of sale.)
O'I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing ,
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 contractors) (rcensed pursuant to the Contractor's License Law.)
i \ Grading
O l am exempt. under.Sec B. & P.C. for this reason
Driveway Enc.
Date Owner Infrastructure'
WORKERS' COMPENSATION DECLARATION,
I hereby affirm that I have a certificate of consent to self -insure, or certificate of '
Worker'e 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.
TOTALi -
CERTIFICATE OF EXEMPTION FROM REMARKS
lz WORKERS' COMPENSATION INSURANCE
(This section need 'not be completed ft 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. S
employ. any person,in'anymanner so as to become subjectto the Workers' Compensation
Laws of California
Date Owner
NOTICE' TO' APPLICANT: f, • after making, this Certificate of Exemption' you, should become . , . ZONE: BY: -
subject to the ,Workers' .Compensation provisions - of the Labor Code,- you must lorthwlth •
comply with such provisions or this permit shall be deemed revoked. ' - _ Minimum Setback Distances:
Front Setback from Center Line
Rear,Setback from Reaarr Pr/op. Line
WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE ISUNLAWFUL, 'AND SitieStreet $etbgck fromCenter-�Qine
.SHALL SUBJECT AN .EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP. to, ONE
HUNDRED THOUSAND DOLLARS. ($100,0W), IN ADDITION TO -THE COST OF COMPENSATION Side Setback from Property. L ne %0
DAMAGES AS PROVIDED FOR. IN SECTION 3706 OF. THE. LABOR CODE, INTEREST, AND ° C/ •• v
ATTORNEYS FEES. V
- FINAL DATE ,\INSPECTOR \'
This is a building pemiifwhen properly filled out, signed and validated, and is subject to
expiration it work thereunder is suspended for 180.days: -
I,certify that.) have read this application and state that,the-above information is correct. Issued by Date P YfTllt
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. Validated by. a -• \ w // f/ i
Signature of applicant Date
Mailing Address Validation <�
,fit
City, State, Zip
CONSTRUCTION ESTIMATE
NO.
ELECTRICAL FEES
NO.
PLUMBIN.W4ES y ,.
1ST FL. SQ. FT. ®
2ND FL. SQ. FT.
POR. SO. FT. ®
GAR. SO. FT.
:CAR P. SQ. FT.
WALL SQ. FT.
SQ. FT. ®
ESTIMATED CONSTRUCTION VALUATION
$
UNITS
+
r
YARD SPKLR SYSTEM
MOBILEHOMESVC.
BAR SINK
POWER OUTLET
ROOF DRAINS
w- 3
DRAINAGE PIPING
'
bRINKING FOUNTAIN.
URINAL
,y
$
WATER.PIPING
NOTE: Not to be used as property tax valuation
FLOOR'DRAIN
? .
MECHANICAL FEES
WATER,SOFTENER
d "
VENT'SYSTEM FAN EVAP.COOL 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,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 ® 3/4c
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 APPJEQUIv-
REINF. STEEL
GAS (FINAL)
TEMP. POLE
=GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
Cu. yd.
$ plus
x$_$
LUMBER GR.
INAL INSP.
"FRAMING
FINAL INSP.
ROOFING
REMARKS:
"VENTILATION
FIRE ZONE ROOFING:
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
-
CERT.00C.
a
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
k
GARDEN WALL FINAL