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002593 (SATT)Building City Lic. # 32R Address c;4_1 Owner New ❑X Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Mailing �— Address� City City PCOM Contractor Minimum Setback Distances: LICENSED CONTRACTOR'S DECLARATION _. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section,' 7000) of ,D✓ivision 3 of the Business -and Professions Code; and my license is in full force grid effect.f....rC`., Address ' City .. .. .. ... • SIGNATURE"'... y 1 , ./ —.. ../ DATE . Zip . A a 44. Q"- - bf _'T P.O. BOX 1504 No. OU 593 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP. A.P. Number i$ Legal. Description Project Description F M $1 We PIPSE 12 A Plan'2 OR' Tel Tela State Lic. & Classif... 29A 110 City Lic. # 32R . M4G ims Sq. Ft. No. Size 424 Stories _ No. Dw. Units Arch.; Engr., Designer New ❑X Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 'Date Owner ' NOTICE TO APPLICANT: If, after making this -certificate of Exemption' you should become City Zip State Lic. # Minimum Setback Distances: LICENSED CONTRACTOR'S DECLARATION _. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section,' 7000) of ,D✓ivision 3 of the Business -and Professions Code; and my license is in full force grid effect.f....rC`., Front.Setback from Center Line ' .. .. .. ... • SIGNATURE"'... y 1 , ./ —.. ../ DATE . OWNER -BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7034.5,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 the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of . Division 3'6f 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 p'?rmit subjects the applicant to a civil penalty of'not more than five hundred dollars'($500)..' , O 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 Professions Code: The Contractor's License Law does not,apply to an owner of property who builds or improves ihereon and who does such work himself. or through his own employees,n provided that' such improvements. are riot intended or offered for sale. If,. however, the building - or improvement Js sold. within one year of completion,:the owner -builder will have the burden, 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- struct the project. (Seca -704 4,. 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 . • such projects with•a contractor(s) licensed pursuant to the Contractor's License Law.) .� I am exempt under.Sec. B. 8 P.C. for this reason Estimated Valuation t - 97,623• I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) - - .PERMIT := ••F: ' AMOUNT ' Plan Chk. Dep. . Plan Chk. Bal. 332.05 Const. �"� p - 427.00 fVMedh. .00 ' Electrical - ' Plumbing�•� 9-30•SEPermit S.M.I. --^.�g'dr• - Grading - Driveway Enc. Date Owner Infrastructure 1,•35 mentioned property for inspection purposes. •' Validated b 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 O. Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM _ - WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the permit' is for one hundred dollars ($100)' valuation Signature of applicant - ; ; - 'rte f� Date Jl •, Mailing Address Validation: TOTAL 2.437.17 ;REMARKS A. 6 .4 2 2 ' or ss.) - 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 ' 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 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 I hereby 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 3 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 9-30•SEPermit certify that I have read this application and state that the above information is correct. Issued by: Date 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 b Signature of applicant - ; ; - 'rte f� Date Jl Mailing Address Validation: City, State, Zip— ipA6422 A. 6 .4 2 2 9 30 2437,17 Cf HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FE NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS 2ND FL. SQ. FT. YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. (k.ROUGH PLUMB. ��'ZZ&g DRAINAGE PIPING WALL SQ. FT. STORAGE TANK DRINKING FOUNTAIN SO FT ® TOUGH WIRING/2 //) T � of v URINAL ESTIMATED CONSTRUCTION VALUATION $ /fJ6FOUND. REINF. /O �� ll�� WATER PIPING NOTE: Not to be used as property tax valuation HEATING (FINAL) FLOOR DRAIN MECHANICAL FEES GAS (FINAL) WATER SOFTENER VENT SYSTEM FAN. EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SERVICE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED BOND BEAM LAUNDRYTRAY AIR HANDLING UNIT CFM GRADING CU. yd. $ plus x$ 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 VENTILATION SQ. 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 SPARK ARRESTOR GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE 7 NST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ,#G PLUMBING /t�� UNDERGROUND A.C. UNIT COLL. AREA // 00U%LSLAB GRADE �Q— z% (k.ROUGH PLUMB. ��'ZZ&g BONDING HEATING (ROUGH) STORAGE TANK A/—FORMS /U� SEWER OR SEPTIC TANK TOUGH WIRING/2 //) T � of v DUCT WORK ROCK STORAGE /fJ6FOUND. REINF. /O �� ll�� iAS (ROUGH) �j METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FI INSP.�jlG BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus x$ =$ LUMBER GR. INS P. �� FRAMING d -22 �v C / SP J%6 /ROOFING p�G�� T l/Y+f /�v {�I< To W'�� D (tom/ yi q 6L l�, A L L y/ /�' / �.2� �� a �/P /"'C� 13 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ZZATHING MESH �A INSULATION/SOUND/,;t FINISH GRADING y INAL INSPECTION ,W CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL