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08454 (SATT)F: P.O. BOX 1504 No. 48454 Building 78-105 CALLE ESTADO Address —Q72 LA QUINTA, CALIFORNIA 92253 " Owner �. .. � N BUILDING: TYPE CONST. OCC: GRP. �r.. - Mailing � .... .. m Address 1111,11 AVT rt, 1:7l1D A.P. Number �A t+iCT — TRACT �}1—�2 City P el. 33 .M n oS� Legal Description �onlractor �� r Project Description HAS'r7 Qdblr�! . Address Mc City _ Zip Tela State Lic. City & Classif. Lic. # Sq. Ft. - �. No. No. Dw. Size Stories Units Arch., Engr., _ _—M - ,:Designer. - f'. New ❑ Add-❑ ".- Alter ❑• Repair ❑ Demolitiori ❑ - Address ' Tel. #y Zip State "'z Lic. # '1 1. t; LICENSED CONTRACTOR'S-DECLARATION ry ' I herebyy affirm��hat I am licensed under provisions of Chapter 9 (commencing with Section 7000) of+Division.31of tfie Business acid Professions Code, and my license is in.full fort ,and SIGNATUR �.. .rrryv..a �� .,.rs•.•^' Ka/ .,;1� �Le U- ` OWNER•BUILDER DECLARATION p/ /f >.• > �.. Estimated Valuation • I hereby affirm that am exempt from the Contractors License Law for the following • reason:2(Sec. 7031.5;Business and Professions Code`.• -'Any city or county which requires a a - •-• • - I' t - t permit do'.construct,alter, improve, demolish, or repair any structure, prior to its issuance also iequires 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) of ,. Division' 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis - -` for the'allegedexemption. Any- violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. subjects the applicant to a civil penalty of not more than five hundred•dollars ($500). - - Plan Chk. Bal. 5640 6 ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Const. do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and ..Professions Code: The Contractor's. License Law .does not apply to an owner of property who Mech. , ' builds or. improves thereon and-.who does such work himself or through his own employees, provided that such improvements are not intended or offered for. sale: If, however, the building , Electrical - or improvement is sold within one. year of completion, the owner-builder will have the burden o312l proving that he did. not build or improve for the purpose of sale.) , Plumbing ❑ I; as owner of the property, am exclusively contracting with licensed contractors to con-_ , ' - struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law S. M, 1. •. - does not apply to an owner of property who builds or improves thereon, and who contracts for ' ? such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading O I am exempt under Sec: B. & P.C. for this reason. - Driveway Enc.' ' "Date owner - Infrastructure ARSS MEDIT WORKERS' COMPENSATION DECLARATION t t� I Hereby affirm that I'have a certificate of consent to self-insure, or a certificate of — D w ' Worker's Compensation Insurance, or a certified copy thereof.'(Sec. 3800, Labor Code.) 'Policy No Company . ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL -_ • .. CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($ 100) valuation or less.) - 1 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..14 , _ Date Owner „` tH3Y'i 3 1 id s riL; a. 51%V,.0 NOTICE TO APPLICANT: if, after making this Certificate of Exemption you should become ZONE: • 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. _ ' 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 ..'FINAL DATE INSPECTOR Lender's Address This isa 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.Issued by: Date Permit 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. - =- Validated by: Signature of applicant Date Mailing-Address i•Valldatlon: ) City, State,' Zip 1 w -iT ,� ,� fa,v! 3?4t s X .�! R: Y^':: ='. �? i.. ) .. y T 7' '� �,,,r �• ,. .•r :.;.fid. 1 .yiiA^. =� �,_" 1! sr. � 7 '.: .-.,Y `` .r •.� ; ;-c". w ..t.,f.. .f..+�,i �< �. .r i,cl xi ,.: S1 � _ r�bi .F �,+ $ . J,ay,i_^':�� _ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. @ CAR P. SQ. FT. WALL SQ. FT. ® SQ FT ® ESTIMATED CONSTFUCTION 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 AS(ROUGH �- �-�� GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL ©lc rO " ' I ��V l���' ^ , / _ `� .�,�- f✓� PC SQ.FT.GAR ® 3/ac HOUSE SEWER - VENTILATION LlGAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL T7TAL 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 PLUMBIN!f-5'qo UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER AA-51�6TdG-1ANIh_y� ROUGH WIRING. DUCT WORK ROCK STORAGE //////���� OUND. REINF.&?- G `� 11 AS(ROUGH �- �-�� METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. d. y $ plus x$ =$ LUMBER GR. �/ /SPINAL INSP. l� L/� /FRAMING / f %1,1PI-/�o� FINAL INSP. OFING G���J ©lc rO " ' I ��V l���' ^ , / _ `� .�,�- f✓� PC REMARKS: - VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL G THING / V MESH '/ /'' V 1NSULATIONISOUND/ '-/i'/°-L/� 0 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL