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08450 (SATT)4 C!I/ PHASE "37A. -BLDG 5- . P.O. BOX 1504 4 N o . 08450 Building 78-105 CALLE ESTADO Address —948 Rty j m LA QUINTA, CALIFORNIA 92253 Owner Tel. City Zip State V BUILDING: TYPE CONST.." OCC: GRP. _ Mailing Address — -nnn -?nn A.P. Number PGA fsi asT - TncT 24M16._5 '" "� 4 City Zip Tel. PAI M S9 Const. Mech. 51,00 R-9828 Legal Description Project Description PHASE 3 01AN 4,1otR Contractor Plumbing 131,00 a<! T A€ Grading Address _ _ _ .. .. .� .. .. LESS Mvnll 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.) ,8.• PUBLI • v 82.94 Policy No. Company ❑ Copy is filed with the city. O Certified copy is hereby furnished. City ""`" Zip Tela -State Lic. City • & Classif. Lic. # Sq. Ft. No. No.'Dw. Size Stories Units 'Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ '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 Wision 3 of th�3e-Business amend Pro es`sions Code, and my lice�yse i�`in full force and . • .SIG_N'ATURE ..v..-�•, 9' if " . Ll O 0ATE '7 ' OWNE UILDER DECLARATION ' �F d ' I hereby affirm tliat,l am exempt from the C2qi`itractor's License Law for the following reason: (Sec. 7031. S, Business and Professions- Cdde: 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 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 civil penalty of not more than five hundred dollars (8500). ' ❑ 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 Estimated Valuation T� �� .L = PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. t Const. Mech. 51,00 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 Electrical 112404 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.) ' Plumbing 131,00 • 0 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.) '❑ I am exempt under Sec. B. & P.C. for this reason S.M.I. 9.31 Grading Driveway Enc. " Date Owner Infrastructure 2488,36 1.494.18 LESS Mvnll 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.) ,8.• PUBLI • v 82.94 Policy No. Company ❑ Copy is filed with the city. O Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) 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 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 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 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 -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip REMARKS 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: 'Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT, ® CAR P. SO. FT. WALL SO. FT. ® SO FT ® ESTIMATED CONSTRLCTION 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 �S (ROUGH) Z� C •�> 1 V GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY 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 ® 11/4 c SEWAGE DISPOSAL D /� -ry `n(� �� j / .� -� U SO.FT.GAR ® 3/ac 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 ROUND PLUMBI f() UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. ___75--57z5 BONDING HEATING (ROUGH) STORAGE TANK FORMS -121R44 EWERAR4EP7dC ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REIN - r 2 - &7 O �S (ROUGH) Z� C •�> 1 V 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$—=$ GR. &F NAL INSP. —(2? Y //LUMBER &CSRAMING - /[/-� FINAL INSP. OFING &p ^�� D /� -ry `n(� �� j / .� -� U REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR FIREWALL /GAR. &LATHING MESH AgSULATIONISOUNV `/G46 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL