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08456 (SATT)Building Address Owner Mailing Address City PALK I Contractor Address State Lic. City & Classif. *100.1 !'ra I Lic. # Arcn., Lngr., Designer Address Tel. 4 4 Qgwa P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 CityI Zip I State I Lic. # LICENSED CONTRACTOR'S DECLARATION I herebyy; affirm that'l am licensed under provisions of Chapter 9 (commencing with Section 700e0)t f, ivisiont3 of the Business arid Professions Code, and nfy icenst sin fuul or e and SI NATURE .rX.Y �-"L-4- �� .JC./^ +' '-a .�,, .r; ��DATE f i OWNER -BUILDER DECLARATION I hereby affirm that Ifam exempt from the Contractor's License Law for the following reason: (Sec. 7031:5;Bdsiness 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 the provisions or 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 subjects the applicant to a civil penalty 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 Contractor's License Law does not apply to an owner of property who builds or improves 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 or improvement 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 contractor(s) 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. Company ❑ Copy is filed with the city. ❑ 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 lhg 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: It, alter 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 shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby 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 properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify 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 sof this city to enter the above- mentioned property for inspection purposes. MSE-37MBLEIG 7/44 No. 08456 LDING: TYPE CONST. OCC: GRP.: P. Number PGA WEST TRACT #21846-5 Description Project Description R msr 37A — 0141 Am— Sq. Ft. No. No. Dw. Size iii. g Stories Units New ❑ , Add ❑ Alter ❑ Repair ❑ Demolition ❑ stimated Valuation 112 >� PERMIT j AMOUNT Plan Chk. Dep. Plan Chk. Bal. —564 26 Const. Mech.— Electrical " Plumbing S.M.I. Grading Driveway Enc. Infrastructure 9 1 494, 19 L566 C T Q si is N R PULL! nt r ••• l4 PLACES • TOTAL 3.198.23 REMARKS 14 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 Issued by: Date Permit Validated by: Signature of applicant Date Mailing Address Validation.: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SQ, FT. ® GAR. SQ. FT, ® CAR P. SQ. FT. WALL SO. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 4iAS (ROUGH) ��_A/) sv 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL J` 'v j�. l�/j1` O SO.FT.GAR ® V4c HOUSE SEWER 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 & AIR COND. SOLAR SETBACK OUND PLUMB bt? UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE GI a'LI� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER AR ArP*I6-17- M M-- ROUGH WIRING DUCTWORK ROCKSTORAGE FOUND. REINFc7 / 'o o� J � 4iAS (ROUGH) ��_A/) sv 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$ =$ LUMBER GR. al/Cl N A L INSP./ x -q &eFRAMING / V FINAL INSP. ROOFING Q"'�O J` 'v j�. l�/j1` O REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL &ATHING l/n f".1- MESH INSULATION/SOUN?- L Q FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL