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001876 (SATT)4 P.O. BOX 1504 No. 001876 Building 54-314 Oak Tree78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner S1113r15e CaVany BUILDING: TYPE CONST. OCC: GRP. Mailin Address 75-005 Ckil ntry Club ?rive A.P.,Number Cklu Desert Z�ip Tel. 5�22$O 558-2829 Legal Description Contractor Project Description P" West nm IQR. Natiowd Land and Nortggge City Zip Tela S� Sam Sam State Lic. City Zi & Classif. Lic. # l Arch.; Engr., Designer Robert Alte ers A ium. Address Tel. 1915 .Red UU Ave. (T14) 56€ 51/7 Ci ,4 ta XWM Zip 92626 State . Lic. # _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm-that�l: am licensed under provisions of Chapter 9 (commencing with,Section 7000) of Division of the Business and Profegsions Code, and my license is in fuullbforma`nd;;,, effect. SIGNATURE - ! / .+' DATE /OWNER BUILDER DECLARATION f I hereby affirm that I am exempt from the Contractors 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 o the Business and Prolessions Code, or that. he is exempt therefrom, avid 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 or not more than rive 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 throughhisown 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.) ❑ 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. . ❑ 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, alter making this Certificate of Exemption you 'should become subject to the 'Workers' Compensation provisions or 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 wherrproperly 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, .. j , i Signature of applicant - r � ' F.- x / Date + J Mailing Address �. City, State, Zip HARD COPY REMARKS 1. AM SPA WT PABX OF THIS PMT NO BLOCK Vats 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^ Permit Validated by: Validation: A 3 2 5 U 11 1 3 L J/ 9, 4 2 CK Sq. Ft. GM 424 Size No. j No. Dw. 1 Stories Units New © Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation -8-00- PERMIT AMOUNT Plan Chk. Dep: . Plan Chk. Bal. 324,94 Const. 391.00 Mech. 34.00 Electrical 59.99 Plumbing 87.50- S.M.I. an Grading Driveway Enc. Infrastructure 1,276.00 TOTAL 2,179.42 REMARKS 1. AM SPA WT PABX OF THIS PMT NO BLOCK Vats 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^ Permit Validated by: Validation: A 3 2 5 U 11 1 3 L J/ 9, 4 2 CK CONSTRUCTION ESTIMATE NO. ELECTRICAL FF111111111k NO. PLUMBING FEES IST FL. SQ. FT. ® 2ND FL. SQ. FT. POR. SO. -FT. ® GAR. SQ. FT. ® CARP. SQ. 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 MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED / J 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 FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ac HOUSE SEWER AFRAMING L2 FINAL INSP. 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 *EWER �i S TI NK OUGH WIRING `� v DUCT WORK ROCK STORAGE 11 FOUND. REINF. / J GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL AS (FINAL) L) 1 TIt / TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ -Plus-X$-=$ LUMBER GR. FINAL INSP. � L AFRAMING L2 FINAL INSP. a4 ROOFING �/ Y REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH ` INSULATIONISOUND IL I FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL I(��a--( - LII�q(Z&ED