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002314 (SATT)*ht 4 P.O. BOX 1504 N o . Building 78-105 CALLE ESTADO Address 54-205 cat RM LA QUINTA, CALIFORNIA 92253 Owner sqse Ckonm1J Mailing Address 75-005 COMAXY C1Ub Drive City Zip Tel. . . Pa3m "De.92260 .568-2828 Contractor Na %=txjajL Address. "City Sam State Lic. & Classif.: 2$8130 Arch:; Engr., Designer Tela" City Lic. # 328 002314. BUILDING: -TYPE CONST. OCC: GRP, A.P. Number Legal Description Project Description PMWEST RM 3 4 PMM 5 A DM 1627 Sq. Ft. OR424 No. .a No. Dw. Size Stories Units New ME Add O Alter 0 Repair 0 ' Demolition 0 Address Tel. City Zip State Front Setback from Center Line Lic. # Rear Setback from Rear Prop. Line _ LICENSED CONTRACTOR'S DECLARATION Side Setback from Property Line 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 1.. INSPECTOR Issued by: effect. 1. // //.. !' ' - �� ,l �". A:i ;: '-i(i1 �i ! .:. �� 'e Validated by: SIGNATURE r ' ' /"/ ' " 11 —DATE , OWNER -BUILDER DECLARATION' p > ' 1 herebyaffirm that I am exempt from the Contractors License Law for the following Estimated Valuation $ reason: -(Sec. 7031.5, Business and Professions Code: Any city or .county whichrequires a . permit to construct, after, 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'Prdiessions Code, or that: he is exempt therefrom, and the basis 7031.5 'any for Plan Chk. Dep. - - for the alleged exemption. Any violation of Section by .applicant a' permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. 364,,,19 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, Buisness and COnSt.�a. w 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. - - . ppp�� 34 provided that' such improvements, are not intended or offered for sale. If, however, ., the building •'•�0 or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 057,41of proving that he did not build or improve for the purpose of sale.) 0 I, as owner of the property, am exclusively contracting with -licensed contractors to con- Plumbing 97.50 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 S.M.I. 7_3-8 such -projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading 0 I. am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date owner Infrastructure ZXM= 1,5 54.98 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 . ❑ Copy is filed with the city. 0 Certified copy is hereby furnished. TOTAL 2,559.76 CERTIFICATE OF EXEMPTION FROM q 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 subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY 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.) Lender's Name Lender's Address 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. I agree to comply with all ciy 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.. .. I d Signature of applicant ' °� "✓ / Date Mailing Address City, State, Zip' HARD COPY REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: 4 23-6 Date Permit Validated by: Validation: A5521 4 21 2558,76 CK CONSTRUCTION ESTIMATE NO. ELECTRICAL FEESdok NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. Ff. ® GAR. SO. FT. ® CAR P. Q. 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 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.IEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB SQ. Ff. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL TO Gu ^rte / SO.FT.GAR ® 3/4c 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 41 ROUND PLUMBING!"61 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE OUGH PLUMB.G BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK OUGH WIRING DUCT WORK ROCK STORAGE 17&/, -'FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL .S a a .10 GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP: FRAMING �O FINAL INSP. / /ROOFING8 J/ TO Gu ^rte / l REMARKS: VENTILATION/ FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL y 2&OLATHING F54 MESH e64INSULATIONISOUND .217 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL I UM'b WUNA I UML51INI I IAL5. GARDEN WALL FINAL K1,/ -U/ /v/ F -(v Uf-L/ k"A%L