001778 (SFD)• u
P.O. BOX 1504
Building 7&105 CALLE ESTADO
Address fl�00 Sp. 82 LA OUINTA, CALIFORNIA 92253
Owner
mamng " -
Address 42-450
PvJm Desert I 922610 I 345--2595
Contractor
State Lic.
& Classif.
-Arch., Engr.,
Designer
Address
Zip j Tel.'
No. 001778
BUILDING: TYPECONST: OCC: GRP.
A.P., Number
Legal Description
Project Description
guy
Lic. # Sq. Ft. No: No. Dw.
Size Stories Units
Tel.
New.❑ Add ❑ Alter 0. Repair ❑ . -Demolition ❑
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 Professions Code, and my license is in full force and'
effect. .. -
_ SIGNATURE _ _ DATE
OWNER -BUILDER DECLARATION
Estimated Valuation
I hereby affirm that 1 am exempt from the Contractors License Law for the following
reason (Sec.. 7031.5:Business and .Professions Code: Any city or county which requires a
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permit to conshuct, after, Improve; demolish, or repair any structure, prior to its issuance also.
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requires the appUcant,for such permit ro Me a signed:statementthathe Is licensed pursuant ro
PERMIT AMOUNT
the provisions o/ the Contractor's License Law, Chapter 9 '(commencing with Section 7000) of
'Division 3 o/ the Business. and Professions Code, or_that.he Is'exempt 'therefrom, 'Sind We basis
•alleged Any Section 7031.5 ,any a
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Chk. Dep.. - -
for the exemption. v1dation of ,by applicant for perms
' subjects the applicant to civil penalty o/ not more than ftve•hundred dollars ($500).
.Plan - -
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, Bulaness and
Const. �,t3
Professions Code: The Contractor's License Law does .not apply to an owner o/ property who
builds or Improves thereon and who does such work himself or through his own employees,
n
- Mecil.
provided that such,.lmprovements 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 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 Cade: The Contractor's License Law
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does apply to an owner o/ property who builds or Improves thereon,, and who contracts for
S. M.1. - -
.not
such projects with a contiactor(s),licensed-pursuant to'the Contractor's Uceqse Law.)
❑ I em exempt under Sec. - d;,'grP:C. for -this assn
GradingDriveway
rr
Enc.
r ?
Date owner-` .. ' ``"`
— Wrastructure
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I haiie'a certificate of consent to self -Insure, or a.certificate of
Worker's Compensation Insurtinze,.ora certified copy thereof. (Sec. 3800; Labor Code.)
Policy No. Company
O Copylls filed wlth•the city. , O Certifiedcopy Is hereby furnished.
TOTAL 200 ,00
CERTIFICATE OF EXEMPTION'FROM
REMARKS
WORKERS' COMPENSATION INSURANCE
(This section need not be completed i/ the permit is for one hundred dollars ($100) valuation
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• or less.) -
f certify that In the performance of thg work for which this permit is Issued, I shall not
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employ any person in any manner so as to' become, subject to the Workers' Compensation
Laws of California.
Date' _Owner
NOTICE TO .APPLICANT: ti, 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
Rear Setback from Rear, Prop. Line
CONSTRUCTION LENDING AGENCY
Side Street Setback from Center Line
Ihereby 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 If work thereunder )s suspended for 180 days. i,
I certify that Fhave read this application and slate tryst the above Informationas_,correct:,
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I
'Issued by- Date U-5-95 Permit
tigrea comply with' all olty and county -or n need and state laws reltiting to building
construction, and hereby duthdrize repres�I t es l of this city to enter the -above-
mentioned property.for i fspectf�t purposes. t.
Validated by:
Signature of applicant-°,. `fI�"'� '��_ Date
Mallin ,Address %''r` �^ -�
Mailing
Validation:
city, State; Zip
A3098,- 1.1 .5,
HARD COPY
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL. SO. FT. ® $
UNITS
COLL. AREA
SLAB GRADE
YARD SPKLR SYSTEM
2ND FL. I SO. FT.
HEATING (ROUGH)
STORAGE TANK
POR. SO. FT. ®
MOBILEHOME SVC.
BAR SINK
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
FOUND. REINF.
DRAINAGE' PIPING
CAR P. SO..F7..®
HEATING (FINAL)
OTHER APPJEOUIP.
WALL SO. FT.
DRINKING FOUNTAIN
SO FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION S
WATER PIPING
NOTE:,Not to be used as property tax valuation
FINAL INSP.
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(AUTO)(DISH)
APPLIANCE DRYER
GARBAGE DISPOSAL
.FURNACE UNIT WALL . FLOOR SUSPENDED
FINAL INSP.
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
FIREPLACE
SO. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 11/4 c
SEWAGE DISPOSAL
SO.FT.GAR ® V4c
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 APPJEOUIP.
REINF. STEEL
GAS (FINAL)
TEMP. POLE
GROUT
WATER HEATER
SERVICE
FINAL INSP.
BOND REAM
WATER SYSTEM
GRADING
cu. yd.
$ plus xE
=$
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 2 /
CERT: OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS,
GARDEN WALL FINAL