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002576 (ELEC)Building Address 80-727 Oak Owner No. Dw. Units Mailing Address Q.0. D= 1000 City ill n A Izip 92253 Contractor Address Sam City ' city . .. Zip. 44 P.O. BOX 1504 No, 002576 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING- TYPE CONST: OCC: GRP. A.P. Number Tel. Legal Description Project Description State Lic. 8 Classif. 4rA36 City Lic. #Sq. Ft. No. Size Stories No. Dw. Units Arch:, Engr., .. _. . Designer New Ek Add ❑ Alter ❑ Repair ❑.. Demolition ❑ Address Tel. Side Setback from Property Line 100 � t l *W F,� ' city . .. zip . State Lic. # . LICENSED CONTRACTOR'S DECLARATION ✓ hereby affirm that I am,licensedunder provisions of'Chapters9 (commencing with Section' 7000) of Division9 of.the Business ,a�ndlProfessions Code�„•a.,"n�`d.�',my,license is in fulFforce'and effect. A6349 _ .. .. .. .. ... .. SIGNATURE N !A 4- vL.+i._i' l-/•' DATE Y OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following 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 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 a permit subjects the applicant to a civil'penalty of not more'than five hundred dollars ($500): O I, as owner of the propertill y,,or.my employees with wages as their sole compensation, w 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, 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 contractors) licensed pursuant to the Contractor's License Law.) O. 1 am exempt under Sec. -B. & P.C. for this reason Estimated .Valuation PERMIT AMOUNT - ' Plan.Chk. Dep. •- ' Plan Chk. Bal. Const. Mech. Electrical - Plumbing S. M. 1. Grading Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION 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. ❑ 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. TOTAL 22.50 REMARKS - - 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. 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 when properly 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 abovetinformation is correct. I agree to comply with all city and county ordinances and'state�laws relating.to building construction, and hereby authorize representatives sof' this city to enter' the above-. mentioned property for inspection-purposesr} Signature of applicant !• li%d E �! ids I- / Date Mailing Address City, State, Zip 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 g��"'Permit Validated by: Validation: A6349 9 16 22.56 CK 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 SO. FT. OTHER APP./EQUIP. 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 WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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 ® 1114 C SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR p 3/aC HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MEC+i.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 INSULATIONISOUND FINISH GRADING. FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL