002711 (SFD) IIII II VIII III I IIII 0344
IE A'
P.O. BOX 1504 No. 002711
Building 78-105 CALLE ESTADO
Address 79-690 1Ax7'IIm14 PalMr. LA QUINTA,CALIFORNIA 92253
Owner
Mailing BUILDING: TYPE CONST. OCC:GRP.
Address 75—MIS CM=trY Cly DriVe A.P. Number
CityZip Tel.
Palm 9226 568-2828 Legal Description
Contractor Project Description VIM V'EST PFUM 33 a
TV*ifC1t1t11. WwUnwIE3 and Tand pUM Iii OR
Address
City Zip Tela
sam
State Lic. City M- 2272
&Classif.z g fl Lic.# 2 Sq. Ft.MR 2 No. No. Dw.
Size Stories Units
Arch., Engr., - "
Designer New Add ❑ Alter ❑ Repair ❑ Demolition ❑
Address Tel.
City Zip State
Lic.#
LICENSED CONTRACTOR'S DECLARATION _
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Sectio
7000)of Division 3,cif the Business and Professions Code,and my license is in4ull"forycce and
effect. !
_SIGNATURE DATE
OWNER•BUILDER DECLARATION Estimated Valuation
I hereby affirm that I am exempt from the Contractor's License Law for the following ' P7+
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 PERMIT AMOUNT
the provisions of the Contractor's License Law, Chapter 9 (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 the applicant to a civil penalty of not more than five hundred dollars($500). '
❑1,as owner of the property,or my employees with wages as their sole compensation,will Plan Chk. Bal. 462.R9
do the work,and the structure is not intended or offered for sale.(Sec. 7044,Bufsness and COf1St.
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. 55+Q
provided that such Improvements are not intended-or offered for sale. If, however, the building iJ
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
50
does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.I. S R,4 `
such projects with a contractor(s)licensed pursuant to the Contractor's License Law.) -
Grading
❑ I am exempt under Sec. B.8 P.C.for this reason
Driveway Enc.
-Dale Owner Infrastructure 2.WO.00
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. Company w +
❑Copy is filed with the city. ❑Certified copy is hereby furnished.
_ 90
TOTAL
CERTIFICATE OF EXEMPTION FROM REMARKS
WORKERS'COMPENSATION INSURANCE
(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 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: 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 permit shall be deemed revoked.
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 is suspended for 180 days.
I certify that I have read this application and state that the above information is correct. Issued by: Date1~ "' Permit
I agree to comply with all city and county ordinances and slate laws relating to building
construction, and hereby authorize representatives of this city to enter the above-
mentioned property for inspection purposes. . // / Validated by:
Signature of applicant 7 r % " Date
Mailing Address Validation:
City, State, Zip r
A6735 11 14 33 .• 3, 90 CK
HARD COPY
CONSTRUCTION ESTIMATE NO. ELECTRICAL NO. PLUMBING FEES
1ST FL. SQ.FT.® a UNITS
2ND FL. SQ.FT.
YARD SPKLR SYSTEM
POR. SQ.FT.® MOBILEHOME SVC. BAR SINK
GAR. SQ.FT.® POWER OUTLET ROOF DRAINS
CAR P. Q.FT.
DRAINAGE PIPING
WALL SQ.FT.
DRINKING FOUNTAIN
SQ FT ® URINAL
ESTIMATED CONSTRUCTION VALUATION $ 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
FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY
AIR HANDLING UNIT CFM KITCHEN SINK
ABSORPTION SYSTEM. B.T.U. TEMPUS 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
SO.FT.®c WATER HEATER
MAX.HEATER OUTPUT,B.T.U. SQ.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 PL.CK.FEE CONST.FEE ELECT.FEE SMI FEE PLUMB.FEE
STRUCTURE PLUMBING ELECTRICAL HEATING&AIR COND. SOLAR
SETBACK ROUND PLUMBI UNDERGROUND A.C.UNIT COLL.AREA
gle LAB GRADE O WOUGH PLUMB..2.j -19 BONDING HEATING(ROUGH) STORAGE TANK
ORMS .. O SEWER OR SE 1C Kfr( UGH WIRING DUCT WORK ROCK STORAGE
C2 If
IF
OUND.REINF. GAS(ROUGH) METER LOOP HEATING(FINAL) OTHER APP.IEOUIP.
liffREINF.STEEL '/e_C J GAS(FINAL) TEMP.POLE
GROUT WATER HEATER SERVICE �INAL INSP. S-
BOND BEAM WATER SYSTEM
GRADING
LUMBER GR. 17
tr_INAL INSP.S— cu.yd.
FRAMING FINAL INSP. �� / $ plus x$ =$
AVE
Ike-ROOFING Q ��/ I,3jL rj� Ole T 6 w�7�p a, �,�--� a`K REMARKS:
VENTILATION `�� logy �y/>\LC 3'�r'y')
FIRE ZONE ROOFING /
FIREPLACE
SPARK ARRESTOR
GAR. FIREWALL
LATHING
MESH
9WNSULATIONISOUND a
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
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.FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS.
h
aF GARDEN WALL FINAL
Page of !
IIIIIIIiillilllllllllllll 04 DAVE STEAVENS
+ 'E Inspection Services
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PROJECT Pim k'1 PROJECT # c ;6CJ.2 •a q
ADDRESS 94 d G 'r (C +/7 CLIENT 6 A I...)GSl• No A 1
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DATE 7 ,-,TU Al ts` c1 aW 2—
BLDG.PERNHT# ARCHITECT (SOL L.it A A(Z c p
ENGINEECONTRACTOR Iel- 0"001 Fi FrL
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INSPECTION TYPE ff
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INSPECTION REPORT
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CERTIFICATION OF COMPLIANCE.To the best of our knowledge,all of the reported work, unless otherwise noted,
0substantially c o pplies with approved plans,specifications and applicable sections of the building codes.This report covers
he lod2tionftt'lti Nork Inspected only and does not constitute engineering opinion or project control.
CERT.NO. "' J~,D INSPECTOR NAME Ad S
DATE 17 ;r(.eA)c Poo Z. INSPECTOR SIGNATURE Q..►.4...
i
Page of
4
I • " ' DAVE STEAVENS
Inspection Services
G PROJECT :�6A WE,5 L-E.GEyas PROJECT # of too;L • 09
! ADDRESS _ht.Jcv'> 17 CLIENT P6,4 cojg 57' A(vA t
DATE Li "P I
BLDG. PERMIT# ARCHITECT 6Po4JA TCN ;
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! INSPECTION TYPE
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CERTIFICATION OF COMPLIANCE:To the best of our knowledge,all of the reported work,unless otherwise noted,
0substantially ies with�approved plans,specifications and applicable sections of the building codes.This report covers
#*Iebo!!<tions�vvork inspected only and does not constitute engineering opinion or project control.
CERT.NO. 400 3 7 3'/8 ' SrZ•� INSPECTOR NAME �A ✓G 5rj A 1JL% ,JQ1
DATE
INSPECTOR SIGNATURE_�� i