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001856 (SATT)Building 54-4558 `: Address Mailing Address City Pab Contractor Address I 44 P.O. BOX 1504 No.. 001850 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC. GRP. VP_ A.P. Number Tel. 560 Legal Description Project Description PCM T90VT . IPTAW 3 0 City' Zip. Sm Tela Sam State Lic. City DM 1627 & Classif. Lic. # 32s Sq. Ft. No. No. Dw. 424 � � .Arch., Engr., Size, Stories Units Designer New ®e Add ❑ Alter ❑. Repair ❑ Demolition ❑ Address Tel. .2915 ftd RM AM. (73.4). 540-5117 City Zip State !D262f; Lic..#. . . LICENSED CONTRACTOR'S DECLARATION . I hereby affirm that I am.licensed under'provisions of Chapter 9 (commencing with�Section• -of 7000) of Division 3 the Business:an`d Professions -Code, and my license is in fu hforcee arfd - SIGNATURE F' -^t' - / / DATE — OWNER -BUILDER DECLARATION -1 hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation 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 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 therefrom: and -the basis ' for Any 7031.5 by 'any for - - Plan Chk: Dep..' the alleged exemption. violation of -Section applicant a permit " subjects the applicant to a civil penalty of not'more than five hundred "dollars ($500). ' - Plan. Chk. Bal. 364.19 ❑ I, as owner of the property, or my employees with wages as their sole compensation, wiu: _ 'do the work, and the structure isnot intended oroffered for sale. (Sec. 7044, Buisness and Co11st.'443.50 . , Professions Code: The Contractor's License Law does not apply Loan owner of property who builds or improves thereon and who'does such work himself or through his own employees, Mech` �' 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 , Electrical 67.41of 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. € 7.50 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. 7. ..- . x1q8 such projects -with a contractor(s) licensed pursuant to the Contractor's License Law.) - - - - Grading O I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date owner Infrastructure 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 O Copy is filed with, the city.. p, Certified copy is hereby furnished. TOTAL 2,558..16 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE - (This section need not be completed if the permit is for one hundred dollars ($100) -valuation �rp�yg� - AMi�st'ra 8'Sls: P= M J.:18 S P M W or less:) - I certify that in the performance of thg 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 forwhich 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 it work thereunder is suspended for 180 days. 11-13 8L�' I certify that I have read this application and state that the above information Is correct. Issued by: Date Permit 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. _ '' . r/ . I . Validated by: Signature of applicant Date /A A7 �f Mailing Address "" f f Validation: City, State, Zip A32%9 11 13 2551& CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FE NO. PLUMBING FEES IST FL. SQ. FT. ® 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ, FT, ® CAR P: SQ. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP.IEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR Q 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 PLUMBINGJ�jf UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE �3 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER ORS (ROUGH WIRING �j �r1 L J d O DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL ,GAS (FINAL) (, ' 1 Cv/ I, l� TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. AKEJNAL INSP. L) !G �-(o / FRAMING FINAL INSP. ROOFING VENTILATION REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL +ATHING MESH t'INSULATIONISOUND 23 1 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL tIAVK-`( W60N1,' 31.2g1Y(/