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14287 (RR)Building Address 52-865 Avenida ©brec]on Owner Ignacio Diaz Mailing Address 52--865 Avenida Obregon City Zip Tel. Lira Quinta 92253 Contractor owner/Builder Address City State Lic. & Classif. Arch., Engr.. Designer Tel. Lic. # i P.O. BOX 1504 No - 76 -495 3.7 CALLE TAMPICO 1 42 LA OUINTA, CALIFORNIA 92253, BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description ate—roo— Ft: No.. No. Dw Units New ❑ Add ❑ Alter ❑ Repair ❑ ' 1 Demolition' ❑ Address Tel. 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•BUILDERDECLARATION Estimated Valuation $��000® I hereby affirm that I am exempt from the Contractor . 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,' atter, improve, demolish, or repair any structure, prior to its issuance also' AMOUNT• requires the applicant for such permit to me a signed statement that he is licensed pursuant to PERMIT 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•b-asis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Plan Chk. Dep. su cts the applicant to a civil penalty of not more than five hundred dollars ($500). , as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal:• [� nnn he work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness'and'_ Const. $•3 Q . v0.%. 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, Mech. - 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 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 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.I. such projects with a contractors) licensed pursuant to the Contractor's License Law.) r ..Grading - - I am exempt under Sec. B. & P.C. for this reason " j' Driveway Enc. Date Owner r' 4''?� f r" 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 G Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL $30.00 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE. (This section need not be completed A the permit is for one hundred dollars (S 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 Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. '{ Front Setback from Center Line Rear Setback from Re r Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback Cente Ine SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,DD0), IN ADDITION TO THE COST OF COMPENSATION, Side Setback from erty DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. A' ThFINAL DATE S is is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. (n/ I certify that I have read this application and state that the above information is correct. Issued by: Da t'I 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 applicant Date Mailing Address Validation: r. City. State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. @b GAR. SO. FT. ® CAR P. SO. FT. - WALL SO. FT. ® SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING I 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.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRYTRAY 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® IIA c SEWAGE DISPOSAL SO.FT.GAR ® 34c 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 d 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$ c$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING �G� /h REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL LGI VN'S WUNA I UXtSIINI l IAL5 GARDEN WALL FINAL