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06505 (SATT)4 P.O. BOX 1504 Building 34-039 Riviera 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Surtrise cot ? Mailing Address 42-600 Cook St., #200 City Zip Tel. Psi Desert 92260 56�--2828 Contractor Address Tela State Lic. City & Classif. 288130 1 Lic. # 328 Arch., Engr., Designer Address Tel. City IZip I 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. • . f SIGNATURE DATE OWNEWBUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Lawfor the following reason: (Sec. 7031.5,13usiress 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 fife 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 exerrption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a chem perna9y of not more than five hundred dollars ($500). ❑ 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 Professions Code: The ContraGor's License Law does not apply to an owner of property who builds or irnproves thereon and who does such work himself or through his own employees, provided that such Improvements are not intended or offered for sale. It, 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 inprove for the purpose of sale.) ❑ I, 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 appy to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason 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. -- mpany ❑ 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 ($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: g, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit sha0 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 property filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certity 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 representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip - 2_ No. ©5505 BUILDING: TYPE CONST. OCC: GRP. A.P. Number PGA, its Tract 24317 —1 Legal Description Project Description Phase 318y �' M 1t)?'1R REMARKS :z!>w f f7 ^ i t!k Lsrt.rt #%t-•,_ 4 ^` f f# i�% FrSl:rti % ';11iliR 7i :! $J. t`r' ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 10113/89 Issued by: Date Permit Validated by: Validation: Sq. Ft. 2272 Size No. . Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $158,646 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. y{tr ,27 Const. 846.00 Mech. 82.50 Electrical 123.02 Plumbing 192.00 S.M.I. 11.13 Grading Driveway Enc. Infrastructure $3.,569.53 1,794.77 %cess Credit 1,784.77 TOTAL $3.743.69 ' ji-/ REMARKS :z!>w f f7 ^ i t!k Lsrt.rt #%t-•,_ 4 ^` f f# i�% FrSl:rti % ';11iliR 7i :! $J. t`r' ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR 10113/89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES? 1ST FL. SQ. FT. ® $ UNITS GRADE 11 2ND FL SQ. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ, FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CAR P. SQ. FT. TEMP. POLE WALL SQ. FT. GROUT DRINKING FOUNTAIN. SQ FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES FRAMING �/1 i WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REMARKS: GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B. -.U. SQ. FT. RESID ® 11/. c SEWAGE DISPOSAL MESH SO.FT.GAR ® 3/ic HOUSE SEWER INSULATION/SOUND —, GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TO—AL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB_ FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETACK OUND PLUMBING DERGROUND A.C. UNIT COLL AREA GRADE 11 ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS BEWER OR SE ROUGH WIRING DUCT WORK ROCK STORAGE FOU REINF. AS (ROUGH) / y/ l METER LOOP HEATING (FINAL) OTHER APPJEQUIP. NF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. AL INSP.t1;.2&09'42rC) FRAMING �/1 i FINAL INSP. ROOFING W REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL °THING �— MESH INSULATION/SOUND —, FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL t