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001936 (SATT)4 P.O. BOX 1504 No. 001936 Building 78-105 CALLE ESTADO Address 55-632 Oak 7rM LA QUINTA, CALIFORNIA 92253 Owner BUILDING: TYPE CONST. V OCC. GRP. R 3 . Mailing Address 7"05 0=vtry Club Driva A.P. Number City Zip Tel. . . Pa3m Deseft 922260 56$-2928Legal Description Contractor VATIM �t—iXMI and- Project Description ' •D• ! NaftgaW Address • Plan 30 10 Sam City ' Zip Tela State Lic. City ;7FZIC MS 2825 & Classif.... Lic. # 328 Sq. Ft. 568 No. I No. Dw. j Arch., Engr., Size - Stories Units . � - - - Designer Pd3ft-t Alm$ AM=A New X31 Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 15% rmilii, AV114. (7141 540-5117 City Zip State t ^ e.E€`Viesa 92526 Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that -1 am licensed under provisions of Chapter 9 (commencing with Section' 7000) iysion 3 of the Business and Professions Code, and my license is in full,force lforcand •, �„r effect.. Div SIGNATURE DATE OWNEWBUILDER DECLARATION ' Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following$ -178,307.00 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 AMOUNT requires the applicant for such permit to file a signed statement that he is'licensed pursuant to PERMIT ' the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of - Division 3 of th'e Business and Professions Code, or thathe' is exempt therefrom, 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 penafty of not more than rive hundred dollars ($500). ❑ I, as owner of the property,.or my employees with wages as their sole compensation, will Plan Chk. Bal. irz s.W do the work, and the structure is not intended or offered for sale. (Sec. i044, Buisness and--COf1St��� Professions Code: The Contractor's License Law does not apply to an owner of property who . t + SO builds. or improves thereon and who does such work himself or through his own employees, Mech. i �, 55.00 Provided 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 of proving that he did not build or improve for the purpose of sale.) O 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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.) Grading 39 0 I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure 2,000,00 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. TOTAL 1 3.485-17 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 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. ' REMARKS PMA .ATS? M WT Pt'3it'T OF TM Phi' ZONE: BY: 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 for which this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to FINAL.DATE INSPECTOR 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. Issued by: Date ermit 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- y mentioned property for inspection purposes: —Validated by: Signature of applicant r - r .✓�_ .� Date ��,f!� Mailing Address Validation: City, State, Zip A353L 12 1.0 ?48517 it HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FE- NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO, FT, ® CAR P. I SO. FT. WALL SO. 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 FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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. SO. FT. ® c BATH TUB BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SO.FT.GAR ® 3/ac HOUSE SEWER FRAMING 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' 3 L ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK DOUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) 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. 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 SIGNATURES/INITIALS GARDEN WALL FINAL