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001984 (ELEC)Building 55--376 Oak Tree Address - subject to the Workers' 'Compensation provisions 'of the Labor Code,' you must forthwith comply with such provisions or this permit shall be deemed revoked. Owner 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 therelrom; and the:basis -for .the alleged exemption. Any violation of Section 7031.5. by 'any applicant for: a permit. smwim Mailing. .. Address .75,,,,005 CoUntl`ir I 44- P.O. BOX 1504 N o . 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. -°OCC: GRP.,. A.P. Number City Zip Tel. Almft2 ��,� Legal.Description Contractor' Mortgage and Imid'. _ Project Description Address u _ Sam .City ... Zip Tel.. . $ Sam State Lic. City & Classif... Lic. # Sq. Ft. No. No. Dw. Arch:; Engr... . _ . .. Size Stories Units .,Designer Newkl Add ❑ 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, arid my license is in full;foorce.and + SIGNATURE - DATE Alter ❑ Repair ❑ OWNER -BUILDER DECLARATION I 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, after, improve, demotish, 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 - subject to the Workers' 'Compensation provisions 'of the Labor Code,' you must forthwith comply with such provisions or this permit shall be deemed revoked. PERMIT 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 therelrom; and the:basis -for .the alleged exemption. Any violation of Section 7031.5. by 'any applicant for: a permit. Plan- Chk. -Dep. subjects the applicant to a civil penalty of not more'than.five hundred dollars ($500). • . p I, as owner of the property,.or my employees with wages as their sole compensation, will • - Plan Chk. Bal. Const. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and t.- Professions Code: The Contractor's License Law does not apply_to an owner of, property who Mech. . 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. 'Electrical' ' 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;) Plumbing • ❑ 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 S.M.L. ' -such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) . ❑ I am exempt under Sec. B. ti P.C. for. this reason Grading Driveway Enc. Date' Owner Infrastructure WORKERS' COMPENSATION DECLARATION This is a building permit'when properly filled out, signed and validated, and is subject to 1 hereby' affirm that I*have'a certificate of consent to.self-insure; or a•ce'rtificate of expiration if work thereunder is suspended for 180 days. I Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) . Policy No. Company Issued by: ' ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. agree to comply with' all city and county ordinances and state laws relating to building . TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS - (This section need not be completed if the permit is for one hundred dollars ($100) valuation • or less.) Validated by: 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. Signature of applicant:` �^ - -'�' ate• <-' Date r ��•r'"'`n 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 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 frorrl 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 EE97iJ certify that I have read this application and state that the above information is correct. 1 Issued by: ' Date «L+'� Permit - agree to comply with' all city and county ordinances and state laws relating to building . construction, and hereby authorize representatives.4of this city to enter the above•, mentioned property for inspection purposes. Validated by: Signature of applicant:` �^ - -'�' ate• <-' Date r ��•r'"'`n Mailing Address Validation: City, State, Zip A3i94 1 9 2250 Ck HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. @ $ 2ND FL. SQ. FT. POR. SO. FT. @ GAR. SQ. FT. @ CAR P. 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 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./EQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SQ.FT.GAR @ 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 PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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. 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