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12782 (AR)F! P.O. BOX 1504 NO. 12782 Building 78.105 CALLE ESTADO Address 52--510 AVe. Obregon LA QUINTA, CALIFORNIA 92253 Owner Jose R. Lopez Mailing BUILDING: TYPE CONST. OCC. GRP. 773-285-026 Address Same - A.P. Number CityZip Tel. Lot 1 Flock 163 La Qufnta, CA, 92253 342-6340 Legal Description Contractor Addition E. Berk -us Project Description A dr0. Sex 1080 C&thedxal Cit` slp CA 92234 Te1564n6009 'h State Ljc.City & Classif. E3 4065©� Lic. # Sq. Ft. No. No. Dw. Size 120 Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Address Tel. City Zip State Lic. # e f LICENSED CONTRACTOR'S DECLARATION 1 hereby,affirm that I am lice eender prbvlsions of dhpter 9 (commencing with Sectipn 000) oI., N'1k19 3 of Business anp PQJofesaions de, and my license is in,(yI f�i rind SIGNATURE ! ! DATE OWNER(BUILDERDECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following$6,276.00 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 requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the 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. 6p subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. 57 5.50 ❑ 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 V Professions Code: The Contractor's License Law does not apply to an owner of property who Const. 9 y�./� ._ builds or improves thereon and who does suchAwork himself or through his own employees, Mech. ny `. 0� 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 19.20 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- Plumbing .63 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. 1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. for this reason Driveway Eno. 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 0 Copy is filed with the city. O Certified copy is hereby furnished. TOTAL 189.33 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)h the performance of the work for Wfiich this -permit is issued, I shall not employ any person in any manner so ad'to beco a T: subject.t�the Workers' Compensation Laws ohCaUforriia • '/ f/ date'•`-�"-r�%�� Owner - J '1 rNOTICE ATO/ APPLICANIf, 'after making•'Ihrs Certificate of—Exemption you should become ZONE: BY: subject to; the Workers'. Compensation, provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permitsh'all be deemed revoked. Front Setback_f,r_o-m C.enter_Lioe— a Rear, etback o��Rea�Prrop. pI CONSTRUCTION LENDING AGENCY Sld!q rS reet`l frOr6tent r L6 I hereby affirm that there is a construction lending agency for the performance of the I Il i I� work for which this permit is issued. (Sec. 3097, Civil Code.) Side, S tback from Property Line Lender's Name FEB 0 9 1994 V� Lender's Address t This is a buildingFINAL DATE INSPECTOR permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I I certify that I have read this application and state that the above information is correct. Issued by: ! Date Permi 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: f "1 Signature of applicant Date - - f Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SETBACK r w UNDERGROUND YARD SPKLR SYSTEM 2ND FL. SQ. FT. SLAB GRADE ROUGH PLUMB. BONDING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL DRAINAGE PIPING CAR.P. SQ. FT. ® WALL S0. FT. WATER HEATER DRINKING FOUNTAIN. FINAL INSP. URINAL SQ. FT. ® FINAL INSP. GRADING cu.yd. - is—Plus—X$—=$ ESTIMATED CONSTRUCTION VALUATION $ LUMBER GR. WATER PIPING NOTE: Not.to.be used as property tax valuation ?,ew4 p 3-6 qq C� i FLOOR DRAIN MECHANICAL FEES REMARKS: WATER SOFTENER VENT SYSTEM -- FAN - EVAP.COOL HOOD SIGN _ WASHER(AUTO)(DISH) APPLIANCE DRYER 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. SQ. FT. ® c BATH TUB MESH SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL FINISH GRADING Q.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE MIT FEE LPL.CK.FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.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 IV 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 FINAL INSP. FINAL INSP. GRADING cu.yd. - is—Plus—X$—=$ LUMBER GR. FRAMING /, / ROOFING 3-<< 5 V ,1 `4, ?,ew4 p 3-6 qq C� i REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL3_!e_g(,/ rrL�% LATHING MESH INSULATION/SOON FINISH GRADING FINAL INSPECTION G h 7 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL