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003189 (SATT)W 4 it Q911AM P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 55-021 Oak x.1.3. LA QUINTA, CALIFORNIA 92253 Mailing Address 75-05 CC=tr7 Club Drive City ZipTel. Pada Desert . 92260 368-2828 Contractor Address �'36B ty.. jZip - State Lic. I City & Class !f.. 288130 Lic. # 328 Arch., Engr., Designer 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 the Business and Professions Code, and my license is in -full force and' effect. 7 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 file a signed statement -that he is licensedpursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or Division 3 of -the'Business and Professions Code, or that. he is"eiempt therefioin, 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 ($500). ❑ I, as owner of the.property, or my employees with wages as their sole: compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does -not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such, improvements are not intended or offered for sale. If, however, the building ; or improvement is sold within one year of completion, the owner -builder willhave the burden .of proving that he did not.build or improve for the purpose of sale.) ' ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Coder The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for, such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) .❑ 1 am exempt under Sec.. B.•& P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. .Company ❑ Copy is filed with the city.. ❑ Certified.copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is :for one hundred dollars ($ 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. Date—' Owner ' NOTICE TO APPLICANT. If, after making this Certificate or 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 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 and 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 City, State, Zip HARD COPY No. 003189 BUILDING: -TYPE CONST. ' OCC: GRP. A.P. Number PGA West Legal Description Project Description ��� 30-6, Plan 1 Building 2 ZONE: BY: Minimum Setback Distances: Sq. Ft. D -T' 133() Size '424 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: - Date AhFA.7 Permit Validated by: Estimated Valuation $96,244-900 PERMIT', AMOUNT Plan Chk.. Dep. Plan Chk. Bal. f► [aa� Const. Mech. ' 1tt;-aft Electrical A �� Plumbing A7 s;:y S.M.I. A A Grading Driveway Enc. Infrastructure TOTAL REMARKS FYP"9�wM CtilTAC i 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: - Date AhFA.7 Permit Validated by: Validation: a� CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. ROUGH PLUMB. NDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. p DRAINAGE PIPING WALL SQ. FT. OTHER APP.IEOUIP. DRINKING FOUNTAIN SQ FT ® GAS (FINAL) TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMING �� GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM REMARKS: 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. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ®1+/a c b SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER MESH 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 PLUM IN O - UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. NDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. �J GAS (ROUGH) /O// 04, &METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. 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. FINAL 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 . ::]