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10483 (SFD)Building Address 54-6-05.0bregon Owner ,Dan Whittier Mailing ' Address 6160 D4 Ai ling Citytt Zip ryry A Lt.t.'t��i' rside /R� 96504 Contractor Address P.O. BOX 1504 NO. 10483 78-105 CALLE ESTADO . LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. - OCC: GRP. n Ave #126 A.P. Number 774-293-015 Tel. Legal Description T^4- • Q ' Project Description SFD t Zip Tel.. Building Address 54-6-05.0bregon Owner ,Dan Whittier Mailing ' Address 6160 D4 Ai ling Citytt Zip ryry A Lt.t.'t��i' rside /R� 96504 Contractor Address P.O. BOX 1504 NO. 10483 78-105 CALLE ESTADO . LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. - OCC: GRP. n Ave #126 A.P. Number 774-293-015 Tel. Legal Description T^4- • Q ' Project Description SFD City Zip Tel.. State Lic. City & Classif. Lic. # Sq. Ft. 1810 'No. No. Dw. >i`.Arch., Engr., �• Size Stories- -- - --Units ; c Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. permit doss not inc rude block cull or City Zip State pool. List of all licensed sub—cont.. ' Lic. # LICENSED CONTRACTOR'S DECLARATION must be postE3Gxon job at all i`. mes. 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 - affect. SIGNATURE DATE OWNER -BUILDER DECLARATION' I hereby affirm that I am exempt from the Contractors License Law for the following 7031.5,Business Code: Any Estimated Valuation 4 �� - reason: (Sec. and Professions city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prfor.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) or 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 Plan Chk. Dep. 2(} {�i+�ti . -'- subjects the applicant to a civil penalty or not more than five hundred dollars ($500). - •, 0 I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. _ - �. 30 CL 97 do the work, and the structure is not Intended or•offered for sale. (Sec. 7044, Buisness and - Professions .Code: The Contractor's License Law does not apply to an owner of property who _ OOf1St. - - •-�_.....,._ ti , _ 657- on :-builds or improves thereon and who does such work himself or through his own employees, �t'7 provided. that such improvements are not intended or offered for sale. If; however, the building M2Ch.'- ' - _ • - A4 _ 00 or improvement is sold within one year of completion, the owner -builder will have the burden . 'ottttrf proving that he did not build or improve for the purpose of sale.) , Electrical - - .� Vstr1, as, owner of the property, am exclusively contracting with licensed contractor's to con-.. Plumbing -1 : � uct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts. for,!. ' - S.M.I. - - 0•- , - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec. B. & P.C. forAhi +reason / Driveway Enc. - t3Q G » ?t3 .00 Date/ "- ` %=.r'�w __ .. :.. fe" .�t., �1.� - - o., Infrastructure ,' -' ?,�.1�2. G4 � WORKERS' COMPENSATION DECLARATION hereby affirm that'I have a certificate of consent to self -insure, or a certificate of. Worker's Compensation Insurance, or a certified.copy thereof. (Sec. 3800,. Labor Code.) _ r, .. Policy No. Company m ,,. . � •. s .+ ,-, s .� a n. .ra.<v. ; q , 6- t "� !Lta , , r 34r 3"f[Copy is filed with the city. ❑ Certified copyis hereby furnished. - ' f iYi •L ` TOTAL 3870.36 3620.36--, 6'20.36-- CERTIFICATE CERTIFICATE OF EXEMPTION FROM REMARKS. WORKERS' COM PENSATIO N INSURANCE (This section need not be completed if the permit is for one hundred dollars ($ 100) valuation• - '• - or less.) I certify that in the performance of 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 BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. .ZONE: 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 Addressyw This is a buildingFINAL permit when properly filled out, signed and validated, and is subject to - . ' DATE'3 INSPECTOR expiration if work thereunder is suspended for 180 days. •,•, i-,:'°1' + K , ., , I certify that I have read this application and state that the above information is correct. Issued by F`' �� Date .Permit - I agree to comply with all city and county ordinances and state laws relating to building i;'�; • �;; construction, and hereby authorize representatives -of "this city to enter the above-..- 5•.} mentioned property for inspection purposes. Validated by' Signature of applicant Date a , Mailing Address Validation.'- City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ, FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ. 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 COLL. AREA FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FORMS GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SEWER LAUNDRY TRAY AIR HANDLING UNIT CFM DUCT WORK 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 TEMP. POLE 1 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL SO.FT.GAR ® 3/ic HOUSE SEWER FINAL INSP. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL,FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE JELECT.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 OUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE 1 GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING, //J IY REMARKS: VENTILATION VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATTI XNG MESH INSULATION/SOUND (� FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL