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003746 (AR)Building 54-301 ®aak. Hill Address Owner Joan Brewer Mailing Addfg�sslttt City Zip Tel. L Qra1-nta . _ 92253 . Contractor P.O. BOX 1504 78-105 CALLE ESTADO LA,QUINTA,.CALIFORNIA 92253 No. 003746 BUIL'DING:­TYPE CONST. OCC: GRP. A.P. Number 769-371-006 Legal Description Project Description Addition to be&—Oom Aaaress.. 759A6602P90 Lanel,' Sut6 P --IQ City Palm Desert Zip 922' 60 Tela. 346-7 375 State Lic. City & Classif. 520826 Lic-11 1148 Sq. Ft. 1-30 Size No. No. Dw. Stories Units Arch:, Engr., Designer " New.❑ Add 11= Alter ❑. Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm -that I em 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 effect. •.c 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 construct, alter, improve, demolish, or repair any .structure, prior to its issuance also requires the applicant for such permit to rile 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 the basis for the alleged exemption. Any violation of Section 7031.5 by 'any. applicant for a permit ' subjects the applicant to a'civil penalty of not more than five hundred dollars (8500). . ❑ 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 thereon and who 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.) Estimated'Valuation �3Q - - PERMIT - - - - AMOUNT plan Chk. De . p - Plan Chk. ;Bal.. 4'172 25 Const. s 0 Mech. a,r°, ��}Q Electrical 20.00 . Plumbing O I, as owner of the properly, 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 ' S.M.I. 3.19 - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec..B. B. 8-P.C. for this reason Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION - " I-herebyaffirm that 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. ❑ Certified copy is hereby furnished. TOTAL REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ,.r•,.�; ,. p• fYe; a �: ; :� .. C_r,o ; �,: (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg work for which this permit is issued; l shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ' Date Owner NOTICE TO APPLICANT: U, after making this Certificate of Exemption you should become subject to 'the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. ZONE: —BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear. Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 1 hereby affirm that there is a construction lending agency for the performance of the " work for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name FINAL DATE Issued by: - Validated by: INSPECTOR Date- 3 /2.5 /$Permit . Lender's Address 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. I agree to comply with all city and county ordinances an'd state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. . mentioned property for inspection purposes. Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR , SUSPENDED OTHER APPJEOUIP. 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.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 APPJEOUIP. 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 IN bPr%; I VM"A blUNA I UNLWINI I IAL,. GARDEN WALL FINAL Desert Sands Unified School District - gg liy- �"�';•. fCjt1� ERTIFICATION OF PAYMENT is. �i1-LICATE®. OF f C 1 ABE SCHOOL FACILITY FEES�1 T0: City of La Quinta DATE: 'Department of Community Development 78-105 Calle Estado La Quinta, CA 92253 ' This is to�iy-t. -developer of which is located at' - within 4. this District, has paid school facility fee imposed purs•na'nt to the autho it generate by o e nmen�eASecti.c i 53 80 `'•rt the ammc of $ covering a total of �) square fe�eet // 6f' ( ) resid,ential. or ( ) industrial/commercial development and that�uil"ing permits for this footage in this development may now a issued by your jurisdiction.. fo•r DESERT SANDS UNIFIED %CHOOL DISTRICT %White - Building Department • FYellow -Facilities Planning • Pink -Accounting • Gold - Developer (10)-37 ~"'