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002331 (ELEC)4 P.O. BOX 1504 Building 54090 Oak HM78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner smiris.-D 0; Mailing Address 75-005 40wx City Zip Contractor Address . SLIM Tel. BUILDING: TYPE CONST. OCC..GRP. A.P. Number Legal Description Project Description State Lica City- Date owner Infrastructure & Classif. Lic. #Sq. Ft. ' No. No. Dw. TOTAL Size - - ••r ..Stories Units ' -Arch., Engr., - Side Street Setback from Line' - 1 hereby affirm that there is a'construction lending agency for the'performance'of the Designer -New EJAdd ❑ Alter ❑ Repair ❑ . Demolition ❑ Address Tel. Lender's Name Lender's Address :. INSPECTOR City Zip State I certify that I have read this application and state that the above information is'correct. Issued by: Lic. # I agree to comply with all city and county ordinances and state laws relating to building • LICENSED.CONTRACTOR'S DECLARATION construction, and hereby' authorize representatives of this city to enter 'the above-, 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 mentioned property for inspection purposes. Validated by: • effect. Signature of applicantDate SIGNATURE DATE- Mailing Address Validation: " OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following �.uR.. A 5 3 3 3 reason: (Sec. 7031.5• Business and Professions Code.: Any city or county 'which requires a HARD COPY 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 thatheis 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 exempttherefrom, and the basis for the Any Section 7031.5 'any for Plan. Chk. Ddp. alleged exemption. violation of by applicant a.. permlt ` subjects'the applicant to acivil penalty of not more than five 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 tfie 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 �y� �' 5 of proving that he did not build or improve for the purpose of sale.) . , , x •Sri'sn ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- -Plumbing • slruct the project. (Sec. 7044; Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improvesthereon, and who contracts.for S.M:I. - - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading .O I.am exempt under Sec.. B: & P.C: for this reason NOTICE TO APPLICANT., It, after making this Certificate of Exemption you should become Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION - I hereby affirm that 1 have a certificateofconsent to self -insure; ora certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. . CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it 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 person in any manner so as to become subject to the Workers" Compensation Laws of California. " Date -"'Owner Front. Setback from Center Line TOTAL REMARKS - ' - Side Street Setback from Line' - NOTICE TO APPLICANT., It, 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 CONSTRUCTIONS LENDING AGENCY - Side Street Setback from Line' - 1 hereby affirm that there is a'construction lending agency for the'performance'of the .Center - work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property. Line . Lender's Name Lender's Address FINAL DATE D.ATE INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to if work thereunder is suspended for 180 days. t+..�..� 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 construction, and hereby' authorize representatives of this city to enter 'the above-, mentioned property for inspection purposes. Validated by: Signature of applicantDate Mailing Address Validation: City, State, Zip A 5 3 3 3 4 21 3500 9 HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ 2ND FL. SQ. FT. @ POR. SQ. FT. @ GAR. SQ. FT. @ CAR P. SQ. FT. @ WALL SO. FT. @ SO, 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 ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL IHOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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. SQ. FT. @ c BATH TUB BOND BEAM SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/4 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 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 APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING V ,/ ^ ( /� (� (/� ✓ (// REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL IIVAYCI,IVR"J oiumAI VMCJ/IIYII IALZk GARDEN WALL FINAL