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002420 (MISC)Building Address Owner Mailing Address 75-005 City 3 3 itDosa C't Contractor Nati Ift Address.... P.O. BOX 1504 No. 002420 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC:.GRP. rfty ClubM. A.P. Number Zip Tel. Q 568--2825 Legal Description Project Description PG M PSM. 31 A and L3md City Sam State Lic. & Classif. 228130 Arch., Engr., - Tela City Lic. # 328 Sq. Ft. No. No. Dw. Size SM IJM• �`S'tories Units New ❑jC Add ❑ Alter ❑, Repair ❑ Demolition ❑ Address Tel. .WORKERS' COMPENSATION INSURANCE City Zip State Lic. # or less.) — - - 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, and my license is in full force and effect. . f / I certify that in the performance of thg work for which this permit is issued, I shall not .. .... .. ... SIGNATURE .P .•A, y ile,, - . - .. DATE 'OWNERaBUILDER DECLARATION I herby affirm that I am exempt from the Contractor's License Law for the following reason:r(Sec. .703 1.5, 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 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 it a perm 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 improves thereon and who does such work himself or through his own employees,M2Ch. 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- slruct- 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 contractors) licensed pursuant to the Contractor's License Law.) ❑. I am exempt under Sec. - B. ti P.C. for this reason Estimated Valuation A T� hC� }�� - A 13,850.00 . 1, - PERMIT ' - c -- 'AMOUNT Plan. Chk. Dep. - Plan Chk. Bal. 67.92 Const. �� , Front Setback from Center Line „ -Electrical ' Rear Setback from Rear Prop. Line Plumbing S.M.I. - I hereby affirm that there is a construction lending agency for the performance of the Grading 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 ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. 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 'by: TOTAL%.. certify that I have read this application and state that'the above information is correct. CERTIFICATE OF EXEMPTION FROM REMARKS .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 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 for which 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 if work thereunder is suspended for 180 days. I 'by: 9y �i CPermlt certify that I have read this application and state that'the above information is correct. Issued Date 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. Validated by: Signature of ' `7 A' f y %% i. j 4 r applicant :. .- Date L- Mailing Addressf t Validation: City, State, Zip % %•' A 5 8 1 8 5 17 73,37 U HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SD. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN SO FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ . GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL 1. 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 APPJEOUIP. 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