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003190 (SATT)Building Address 55-009 Oak E111. Owner sr rP AA cayman Mailing Address 75-005 Comtry C City Zip Palm .Desert.92260 Contractor iGtrlP4m�r�� 1i7a1t'tr�a�w Address V�isJ QUA& P.O. BOX 1504 N 0. 003190 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP. Drive A.P. Number - PGA West Tel. Legal Description. Project Description Phase 30A, PlAn City Zip Tel.' State Lic. & Classif. 2� Arch., Engr., ' Designer Address City Lic. # 3.26 Sq. Ft. D76 1627 Size r - .424 New ❑ Add C Tel. No. No. Dw. Stories Units Alter ❑ Repair ❑ Demolition ❑ 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 the Business and Professions Code, and my license is in full force and effect. SIGNATURE `- - - DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following yq N.g$ ��� $ ' reason: (Sec. 7031.5,Business and Professions Code: Any city or county, which requires a ' permit to construct,' atter, 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 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 theiefrom, and the`'basis - - for the alleged exemption. Any violation of Section 7031.5 by any applicant for a'permil Plan Chk. Dep. ' subjects the applicant to a civil penaffy of not more than five -hundred dollars ($500). Plan .Chk.. Bal. . ❑ 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 G�a� Cionst. �? _ Professions Code: The Contractor's License Law does not apply to an owner or property who s+7 . builds or improves thereon and who does such work himself or through his own employees, Mech. 3b . provided that such improvements are not intended or offered for sale. If, however, the building -have s-bs or improvement is sold within one year of completion, the' owner -builder will the burden Electrical 67041 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 slruct 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. 1. �, such projects with acontractor(s) licensed pursuant to the Contractor's License Law.) d . ' Grading ❑ I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date Owner Infrastructure 1.,705.91 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. ❑ Certified copy is hereby furnished. TOTAL�y7Ja� _ 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 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 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. 'and ®/�/J! Issued by: Date ® Permit . I agree to comply with all city 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 by: Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ i I 2ND FL. SQ. FT. POR. SO. FT. ® GAR. 1 SO. FT. ® CARP. SO. 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 FLOOR DRAIN I MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN i EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) KITCHEN SINK ABSORPTION SYSTEM. B.T.U. TEMP USE PERMIT SVC WATER CLOSET COMPRESSOR HP POLE, TEMIPERM LAVATORY HEATING SYSTEM 4FORCED GRAVITY AMPERES,SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB 1 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ac HOUSE SEWER ,/ FINAL INSP. �C{� ROOFING Gf j�7 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 I PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK /r} 14. GROUND PLUM ING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE I ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS l SEWER OR �7 OUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. 7 GAS (ROUGH) /,g *OMETER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL I GAS (FINAL) TEMP. POLE GROUT } WATER HEATER SERVICE FINAL INSP. BOND BEAM 1 WATER SYSTEM GRADING CU. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. 1/ FRAMING 91"1171 d ,/ FINAL INSP. �C{� ROOFING Gf j�7 ' . REMARKS: VENTILATION FIRE ZONE ROOFING r FIREPLACE SPARK ARRESTOR GAR. FIREWALL l , LATHING MESH i INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. t FENCE FINAL j. . INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL