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13243 (SFD)L ;4 P.O. BOX 1504 No. 13243 Building 51-3-.V. obregon 78-105 CALLE ESTADO Arld ? e LA QUINTA, CALIFORNIA 92253 ogon�er Meyer Mailing Address 39857 Desert Sun. City Zip lTel. - Rancho Mirage] CA 92270 328-3480 Contractor Chiner/Suilder Address Zip State Lic. City & Classif. Lic. # Arch., Engr., Designer Address Tel. City Zip Lic. # State LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70 fOO) of Division 3 of the Business and Professions Code, and my license is in full force and ef act . SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the ContractOrjs License Law for the following reason: (Sec. 7031.5.Business and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, 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 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 rive hundred dollars ($500). 0 1, 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 of 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.) 0, 1, 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 contractor(s) licensed pursuant to the Contractor's License Law.) 0 1 am exempt under Sec.—B. & P.C. for this4eason Date . .... . Owner 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 — 0 Copy is filed with the city. 0 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 (S100) valuation or less.) I certify that in the performance oflt�p work fo'k which this permit is issued, I shall not employ any person in any manner so as to.becomb subject to the Workers' Compensation Laws of Califqrnia.. _. N .- - ... Date__LL__-'owner _,�_ —' 1" 11 . — NOTICE TO APPLICANT: If, after making this 'Certificate of Exemption you _ih—ould become subject to the Workers' Compensation provisions, of the Lab'Or 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 it work thereunder is suspended for 180 days. I cer tify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre§entatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant —Date Mailing Address City, State, Zi BUILDING: TYPE CONST. OCC'. GRP... A.P. Number 773-091-002 Legal Description L ot 2 Block 19 Project Description SFD ZONE: BY: Minimum Setback Distances: Setback frjorn Center Line Sq. Ft. Size 1650 No. Stories No. Dw. Units New 0 Add 0 Alter 0 Repair 0 Demolition 0 Permit does not include block wall or pool. '0 Issued by:— Date iPermi I`Qxf Validated by:-- Validation: Estimated Valuation $100,328.00 PERIAT AMOUNT Plan Chk. Dep. 250.00' Plan Chk. Bal. 294.74 Const. 643.00 Mech. 49.00 Electrical 130.65 Plumbing 160.50 S. M. 1. 10 . 10 Grading 20.00 Driveway Enc. 00 Inf rastructure 2,138.33 Precise F an 25.00 Ar,ts,in Publi- Places 25.00 TOTAL 3_1746.32 N .3,471.32 REMARKS ZONE: BY: Minimum Setback Distances: Setback frjorn Center Line qear Setback from Rear Prop. Line Side S e from C nter Side S f ertyUne FINAL DATE— '0 Issued by:— Date iPermi I`Qxf Validated by:-- Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ UNITS SLAB GRADE 16bl ROUGH PLUMB. 2-2 -c? qW BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. @ GAS(ROUGH z 2 +V4 a METER LOOP GAR. SO. FT. @ POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO. FT. @ GROUT WATER HEATER WALL SO. FT. @ FINAL INSP. DRINKING FOUNTAIN. BOND BEAM WATER SYSTEM URINAL SO. FT. @ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FRAMING Z WATER PIPING NOTE: Not to be used as property t5x valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYEA FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE LAUNDRY TRAY AIR HANDLING UNIT CFM 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 SO. FT. g c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. Fr. RESID @ 11/4 c SEWAGE DISPOSAL SQ.FT.GAR @ 3/4c HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE PERMIT FEE TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT.FEE SMIFEE PLUMB. FEE STRUCTURE Z PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK f'op/ GROUND PLUMBING?—? UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 16bl ROUGH PLUMB. 2-2 -c? qW BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. GAS(ROUGH z 2 +V4 a METER LOOP HEATING (FINAL) OTHER APPJEQUIP. R.EINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING 0 _cu. yd. $ _plus_x$_=$ LUMBER GR. FINAL INSP..5--/ FRAMING Z FINAL INSP. ROOFING Lo REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 1-4—,Iq cD MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES11NITIALS GARDEN WALL FINAL -rl c " �x o-/' Z -z i:, io.� , fz. /- � -,4,, �� /0 We5 16 -' /- 6' �- R; eed—Y k 704(� � 1 4 j 5Y V- 6 v Y.1 74A- -e L,, -e