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001561 (BLCK)Building 52-841 �& Address Owner Lic. # Sq. Ft. Size ><. o. No. Dw. . Stories Units Mailing New 9 Add ❑ Alter ❑ ... Repair ❑ -Demolition ❑ A Address Tel. City Zip Tel. T — ea i --A-- sldfHL'9 State Contractor Address .. .. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. C-01561 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description- ip Tela State Lic. `""` City & Classif.. Lic. # Sq. Ft. Size ><. o. No. Dw. . Stories Units .. Arch.; Engr., Designer New 9 Add ❑ Alter ❑ ... Repair ❑ -Demolition ❑ A Address Tel. !0Q bij� ft. (pi 6- ` $;i gh 'reMb'Mod ferm. 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, and my license is in -full force and effect. . _ SIGNATURE DATE 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 consliuct, alter, improve; demolish, or repair. any structure,. prior. to its issuance' also requires the applicant for such permit tofile 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, of that. he isexempttherefrom, and the basis.._. for the alleged exemption. Any violation of Section, 7031,5 by .'any applicant. for apermit ' subjects the applicant to a civil penalty'of not more'than five hundred dollars ($500). ' ' '' ' •. _❑ 1, as owner of the property, or my employees.with wages as their sole compensation, will Estimated Valuation '.�A!!Ei J a ' - PERMIT • AMOUNT - - Plan Chk. Dep. - FIan.Chk. Bal. Const.. �� 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. ,g„however, the building.'; Mech. Electrical or improvement is sold within one year or completion, the owner -builder will have the, burden of proving that he did not build or. improve for the purpose ohsale.) Plumbing ❑ I,.as owner of the property, am exclusively contracting with licensed contractors to con- - struet 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-.I. such projects with a contractor(s) licensedpursuant to the Contractor's License Law.) ❑ I am exempt under -Sec. ' =' B. 8 P.C. for this reason` Grading Driveway Enc. f, ry Date.Owner Owner sr _ 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.. O Certified copy is hereby furnished. TOTAL A. REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATIONANSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or /ass:) 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 Workeis' Compensation provisions of. the Labor Code; you must forthwith comply with such provisions or this permit shall be deemed revoked. • - 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. A agree to: comply with all city and county ordinances and state laws, i6latind to building construction, and hereby authorize representatives; -6f this city to .enter the above-. mentioned property for inspection purposes. 1, Signature of applicantV i' e-` �+ Date - ISSued.by: Validated by: = Date Permit - Mailing Address Validation: City, State, Zip A1537 6 12 20,00 Ch HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SQ. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APP.IEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 71/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: VENTILATION 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 t 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.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 INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL