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002516 (RPL)cei4 4 41auba P.O. BOX 1504 NO. UUZ515 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP. A.P. Number _ Legal Description Project Description' PM MST PHAW9h 68—"S rlexm Road -City Zip Tel." Cates CLt'V 92236 328--2601 Building2-45 _ Address ��x Owner Mailing - Address 75-005 CbLmtxv Club E City Zip Palm Desert 92260 Contractor Bim' -63- 7.wv%l rz4.6"y-+ir Address . . - _ Tel. State Lic. & Classif.-,796 City Lic. # 69 Sq. Ft. Size No. No. Dw. -Stories Units Arch., Engr,; ._ _. Designer New ❑, Add ❑ Alter ❑. Repair ❑ Demolition ❑ Address Tel. Front Setback.from.Center Line City Zip State .Lic. # - Side Street Setback from Center Line hereby affirm that there is a construction lending agency for the performance of the . 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 Bdsiness;and Professions Code, and.my.license is in full force and ' t' Side Setback from Property Line - DATE SIGNATURE' DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following•�_� reason: (Sec. 7031.5,Business and Professions Code:- Any, city or county which requires a permit to oonstiuct, 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 of the Business and Professions Code, or that. he is exempt therefrom, and life basis for the alleged exemption. Any violation of Section. 7031.5 ,by 'any applicant for a permit. subjects the applicant We civil penalty of not more than five hundred dollars ($500).- ' 0.1, 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, Bussness and Professions Code: The Contractor's License Law does- not apply to an owner of property who builds or improves thereon and wh.o does such work himself or through his own employees, _ 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 of proving that he did not, build or improve for the purpose of sale.) - • 0 1,'as owner of the property, am exclusively contracting with licensed contractors to con- 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. & P.C. for this reason Estimated Valuation . PERMIT ^ ' r �• AMOUNT - Plan Chk: Dep.. - _ " Plan Clik: Bal." ,a 2 COr1St.�n`a` C3 Mech. .25.00 Electrical' ,, Plumbing 18.00 - 'S,M:I. - �� Grading mentioned property for inspection purposes d f f Driveway Enc. Date Owner Infrastructure Mailing Address _ . _ - Validation: WORKERS' COMPENSATION DECLARATION I hereby' affirm that I' have 'a "certificate of consent to self -insure, or acertificate of Worker's Compensation Insurance,or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. m Company 0 Copy is, filed.with the city. 0 Certified.copy is hereby furnished. .. OF EXEMPTION FROM 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 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. City, State, Zip -. A614Z 8 6 2 9i, 7.9 CK TOTAL 290±19CERTIFICATE REMARKS . - - . -- Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: subject •to the Workers' Conmpensation 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 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 ' This is a building permit when properly filled out, signed and validated, and is'subject to expiration it 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 SIM Permit •� 1 agree to comply with all city'and county ordinances and state laws relating to building "3�:3YJ ' b construction, and hereby authorize representatives -of this city to enter the abovew. mentioned property for inspection purposes d f f Validated by: Signature of applicant`-;' Mailing Address _ . _ - Validation: . City, State, Zip A614Z 8 6 2 9i, 7.9 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. 'I SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CAR P. SQ. FT. WALL SQ. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP./EOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SQ. FT. Q c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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./EOUIP. 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL