10933 (BLCK)P.O. BOX 1504 No. 10933
Building
Address 52-500 JUA&E2 LA QUINTA, CALIFORNIA 92253
Owner
JAMES SATTLEY BUILDING: TYPE CONST. OCC: GRP.
Mailing
Address 41-625 ECLECTIC GI
A.P. Number
CityZip Tel.
PALM DESERT 92260 340--1361 Legal Description
Contractor Project Description BLOCK 'BALL 150' 8 2'
JAMES SATTLEY
Address. _ -
SAME
City Zip Tel.: -\
State Lic. City
& Classif. Lic. # Sq. Ft. No. No. Dw.
Size Stories Units
.Arch., Engr:, -. .. ... -.
Designer New ❑ Add ❑ Alter O Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic. #
LICENSED CONTRACTOR'S DECLARATION y
I hereby affirm that,l'am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of tlie Business and Professions Code, and my license is in full force and
effect'
S GNAT { F A DATE .
I'hkU5y ER -BUILDER DECLARATION.
Estimated .Valuation
I hereby affi m%1. am exempt from the Contractor's License Caw for the following
reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires, a
permit to copQ"strucI atter, improve, demolish, or repair any structure, prior to its issuance also
requires thelapplicant for such permit to file a signed statement that he is licensed pursuant to PERMIT `' AMOUNT
the provisio s of the Contractor's License Law, Chapter9 (commencing with -Section 7000) of '
Division 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 applicant for a permit Plan Chk. Dep. -
' subjects theapplicant to a civil penally of not more than live hundred dollars .($500). Plan Chk. Bal.
❑ I, 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, 0
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 ' e
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 improve for the purpose of sale.) - -
❑ 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 contractor(s) licensed pursuant to the Contractor's License Law.)
❑ I am exempt under Sec. • B. t;< P.C. for this reason 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 Compensation Insurance,. or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No.t, Company '
Copy�is filed with the city. ❑ Certified copy is hereby furnished:
,J` N� TOTAL
( CERTIFICATE OF EXEMPTION FROM REMARKS
�t WORKERS'COMPENSATIONINSURANCE
(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 the work for which this permit is issued, I shall not
employ any W
person in any manner -so as to become subject to the'orkers' Compensation
' '
LawsCalifornia.
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 Minimum Setback Distances:
comply with such provisions or this p it shall be deemed revoked.
_ Front Setback from Center Line
Rear Setback from Rear. Prop. Line
CONSTRUCTION LENDING AGENCY
. I hereby affirm that there is a�construction lending agency for the performance of the Side Street Setback from Center Line
work for which this permit is issued`(Sec. 3097, Civil Cede.) 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 r.
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. Issued by: Date Permit
I agree to comply with all city and county ordinances and state laws relating to building v
construction, and hereby authorize representatives .of this city to enter theabove-.
mentioned property for inspection purposes. Validated by:
Signature of applicant Date
Mailing Address Validation:
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
2ND FL. SQ. FT.
POR. SQ. FT. ®
GAR. SO. FT. ®
CAR P. SO. FT.
WALL SO. FT. ®
SQ FT ®
ESTIMATED CONSTRUCTION VALUATION $
UNITS
MOBILEHOME SVC.
POWER OUTLET
YARD SPKLR SYSTEM
BAR SINK
ROOF DRAINS
DRAINAGE PIPING
DRINKING FOUNTAIN.
URINAL
WATER PIPING
NOTE: Not to be used as property tax valuation
FLOOR DRAIN
MECHANICAL FEES
HEATING (ROUGH)
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
DUCT WORK
GARBAGE DISPOSAL
FURNACE UNIT WALL FLOOR SUSPENDED
LAUNDRY TRAY
AIR HANDLING UNIT CFM
HEATING (FINAL)
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.
SQ. FT. ®c
BATH TUB
BOND BEAM =s
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11% c
SEWAGE DISPOSAL
LUMBER GR.
SQ.FT.GAR ® 3/ac
HOUSE SEWER
FRAMING
FINAL INSP.
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 Z 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 =s
G
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
FINAL INSPECTION / A
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
GARDEN WALL, FINAL