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002310 (SATT)I_0�"#4 ! - 1 I I Building Address 54-265 0& X11 Owner Mailing Address 75 -WS Counf= Club City lZip ITel. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 POM Desut 922 8-2828 Contractor Address .. No. 0023.0 BUILDING: TYPE CONST: OCC: GRP. A.P. Number Legal Description Project Description M WfigT' FILM 2 4 PbjELW 5 A s City .. Zip Tela . saw State Lic. City1548 & Classif. ., Lic. # 32s Sq. Ft. No. No. Dw. Size -•� 424 Stories Units Arch.; Engr.,' Designer New ❑IA 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'Section 7000) of Division 3 of thea .Business nd.Professions Code, and my license is in full forceand' effect, SIGNATURE r DATE .... .,.. `rOYUNER-BUILDEIi�DECLARATION^ EStlmated Valuation I hereby affirm that I amiexempt from the Contractor's License Law for the following n•� reason;/(Sec, 7031.5,Business and Professions Code: Any city or county ,which requires .a 'permit 7 0 '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 Professions Code, or that. he 'is exempt therefrom, and the basis Any violation Section 7031.5 'any for - Plan Chk. Dep. - for the alleged exemption. of by applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). . Plan Chk.. Bal. 3S2.QnAr5L ❑ 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 Const. r"y�.7./.ryu 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. 34.00 . 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 65.44 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 - 87.50 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. 6..83 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading ❑ I am exempt under Sea B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure 1,464.35 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. .O Certified copy is hereby furnished. TOTAL 2,437.17 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 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 Setback Distances: comply with such provisions or this permit shall be deemed revoked. Minimum 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 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: Date Permit I agree to comply with all city and county ordinances and state laws 1relating to building construction, and •hereby authorize representatives got this city to enter the above-. mentioned property for inspection purposes. Validated by: y. Signature of applicant �' f#' .:. • s Date •' f f+ Mailing Address ` Validation: City, State, Zip r A532..b 4._ 21 2457,1.7 LK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL EESaINL NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. FT. ® CARP. 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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. SQ. FT. ® c BATH TUB WATER HEATER SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL BOND BEAM 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 PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 44,CPUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK A:I�OUGH WIRING DUCT WORK ROCK STORAGE ecieFOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL a GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. )(�CFRAMING If. G FINAL INSP. ROOFING �, �O��� f REMARKS: VENTILATION FIRE'ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL yb LATHING !� MESH 'LkJNSULATION/SOUND nO C� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL mbrecium )awnsiumrwiniIiwLs. GARDEN WALL FINAL f c�,L- S( /&/ 5 --Co 0P-.(.vYD, iC.