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06535 (SFD)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 54-640 Riviera LA QUINTA, CALIFORNIA 92253 Owner Mailing Address 42-600 Cook St., 02-00 City Zip Tel. Palm Desert. 92260 1 568-2028 Hational Mortgage Address Zip I Tel State Lic. A I City & Classif. 2v$13fl Lic. # _ 3W Arcn., tngr., Designer Address CityI Zip 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. _SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8rrskress 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 Na 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 exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civd 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 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractors License Law does not apply to an owner of property who builds or knproves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden 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- 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 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 1 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. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (This section need not be coopleted H the permit Is for one hundred dollars ($100) valuation or less.) 1 certify that in the performance of the work for which this permit is issued, I shall not employ anyppeerson in arty 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 10 the Workers' Compensation provisions or the Labor Code, you must forthwith comply with such provisions or Oris permit shall 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 Lenders Address This is abuilding permit when properly 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 No. ©5535 JP 37 BUILDING: TYPE CONST. OCC: GRP. A.P. Number PG& West - Tract 24317-I 31 Description µ ect Description Fht ao 2E", Platt G2A Sq. Ft. 3355No= No. Dw. Size • Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ estimated Valuation $243,165 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $ 92,:.t% Const. 1,143.5 Mech. 8i, Sfl Electrical MAI Plumbing 180.50 S.M.I. 17.0 Grading Driveway Enc. Infrastructure !��,,_ uGsa Credit 2,733-7.0f, TOTAL REMARKS x..; a A_)% u n(t��� ; rs._ .;... y�ll<.%.. ppclyr; 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 10/16/89 Issued by: Date Permit Validated by: Validati CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SQ. FT. ® $ UNITS ROUGH PLUMB. BONDING 2ND FL SQ. FT. STORAGE TANK YARD SPKLR SYSTEM SEWER OR SE V9RQ?�) ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ, FT. ® AS (ROUGH/[ L d METER LOOP HEATING (FINAL) GAR. SO. FT. ® POWER OUTLET ROOF DRAINS DRAINAGE PIPING CAR P. SO. FT. ® FINAL INSP. WALL SQ. FT. WATER SYSTEM DRINKING FOUNTAIN. SQ FT ® LUMBER GR. URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.FT.GAR ® 3Lc HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOFAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR S ACK HND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA r GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK S SEWER OR SE V9RQ?�) ROUGH WIRING DUCT WORK ROCK STORAGE OUND. REIN AS (ROUGH/[ L d METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ plus x$ =$ LUMBER GR. MNAL INS -6 -If GFRAMING ? FINAL INSP. 46OOFING02- /� ( ' � (J REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL A&THING .^- MESH INSULATION/SOUND 72 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL