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001848 (SATT)all 4bf44Q 54-188 Oak TreeP.O. BOX 1504 Building 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Mailing Address 75-Wqy tr Club Drive City Palm Desert Z1§2260 Tel. 563-2828 Contractor Natt1 lAmd and Portgage Address . Sam City Sae Zip Sau3 Tela State Lic. City & Classif. Lic. # 328 Arch., Engr., Designer Hobert Al•tevers Assoc. Address Tel. Z915,Red Hill Ave. +7143 540-'5117 City Zip State Costs Ise 92626b Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirmthat I am licensed under provisions of Chapter 9 (commencing with Sectio 7000) of Division 3 of the Business and.Professions Code, and my license isslln'full for an, 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, 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 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 ($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 improvesthereon 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 or completion, the owner -builder will have the burden of proving that he did not build or_improve for thepurpose or sale.) ❑ I, as owner of the property, 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 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. . O 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 ($100) valuation -orless.) - — I certify that in the performance of tha work for which this permit -is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner V NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) - Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. 1 certify that I have read this application and state that the above information is correct. I agree to comply'with"all city and county ordinances and state laws relating to building construction, and hereby authorize` representatives of this city to enter the above-' mentioned property for inspection purposes. , i Signature of applicant.. -•-T •fir � �•./��. e l' Date., Mailing Address City, State, Zip / HARD COPY No. 001848 BUILDING: TYPE CONST. OCC. GRP.' A.P. Number Legal Description Project Description PGA WWT PLM 4 DWG 190 Sq. Ft. 424 No. 1 No. Dw. 1 Size Stories Units Newyf� Add ❑ Alter ❑. Repair ❑ ' Demolition ❑ 3timated Valuation BY: PERMIT AMOUNT Plan Chk. Dep. . Plan Chk. Bal. JVJ •OU Side Street Setback from Center Line .Mech. 44.tJU Electrical INSPECTOR Plumbing 8 7 . S.M.I.. X3.310 Grading Validation: Driveway Enc. Infrastructure a •y TOTAL 6�23'9I •�f REMARKS_ ":"A �r;$L7bs £31'11' 8C3 a6iil X .Pt li:Jk'4 .:3�1LirJI.Y 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 11-12 5Permit ,Validated by: Validation: A3216 11 13 _2.891.56 ft CONSTRUCTION ESTIMATE NO. ELECTRICAL Eajilk,, NO. PLUMBING FEES 1ST FL. SO. FT. ® 2ND FL. ' SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SQ. 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 WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 77 l t EWER OR SEPTIC A� GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. 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 V/3/0 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. HEATING (ROUGH) STORAGE TANK FORMS 77 l t EWER OR SEPTIC A� �yB.ONDING TROUGH WIRING'117140 DUCT WORK ROCK STORAGE L� FOUND. REINF. %'2 / GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEOUIP. REINF. STEEL � AS (FINAL) ,L/ ,D TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. rLFINAL INSP. n FRAMING ✓� ' Y,ef VVVi FINAL INSP. ROOFING /� b REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING `MESH F INSULATION/SOUND TrIN FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL