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05022 (SFD)54L� 4.4u,u'cv P.O. BOX 1504 No. 05022 Building 78-105 CALLE ESTADO Address 54-973 Riviera LA QUINTA, CALIFORNIA 92253 Owner Mailing s a" ~ r BUILDING: TYPE CONST. OCC: GRP. Address 42-600 Cook Street, $Uite .200 A.P. Number PGA Hest — Phase 2FC CityZip Tel. 'Dalin Desert 192260.568-2828 Legal Description Contractorpjg� FSA t�atdoua.I Horte ajze Project Description Address I; ani+ r City Zip Tel. State Lic. City & Classif. 288130 Lic. a 328 Sq. Ft. 203 No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. If LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter.9 (commencing with Section 7000) t.of Division 3 of the Business and Professions Code, and my license is in full force and effec SIGNATURE DATE OWNEWBUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractors License Law for the following'," 1? li reason: (Sec. 7031.5,Buslass and Professions Code: Any city or county which requires a permit to constnrat, after, Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to We 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 Mat. he is exempt therefrom, and the basis for the alleged exemption. Any violation rof 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). O 1, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 2 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Const. Professions Code: The Contractor's License Law does not apply to an owner of property who 728,00 builds or improves thereon and who does such work himself or through his own employees, Mech provided that . _ w such improvements are not intended or offered for sale. If, however, the building _ On or improvement is sold within one year of completion, the owner -builder will have the burden Electrical of proving that he did not build or improve for the purpose of safe.) i ' q Q A ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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 S.M.I. 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 94,887.09 2..443.55 ria i IslaQ_ 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL S4_filal _C!1 fI`P'ifll t'`/ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed i1 the pent is for one hundred dollars (5100) valuation or less.) I certify that in the performance of the 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 aliforniaDateOwner NOTICE TO APPLICANT: 8, after making this Certilicate 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 car lity 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 y� g ! LSp Sp} �PY, tTi ; ` 3 t` A t4 1 C+•t?a.a 4 �� 4 vvi 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 2122 %Mrmit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS LAB GRADE 2ND FL SO. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CAR P. I SO. FT. T P. POLE WALL SO. FT. GROUT DRINKING FOUNTAIN. FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation _$ FLOOR DRAIN MECHANICAL FEES ING ( 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, TEM/PERM 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 MESH SO.FT.GAR ® 3/ac HOUSE SEWER SULATION/SOUND 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 FTBACK RO ND PLUMBIN��� UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS ER OR SEPTIC T4SP ROUGH WIRING DUCT WORK ROCK STORAGE 1-16ND. REINF. S ( UGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL FINAL) T P. POLE GROUT ATER HEATER ICE (� FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. ING ( FINAL INSP. I�FtNG � REMARKS: VENTILATION FIRE ZONE ROOFING - FIREPLACE SPARK ARRESTOR GAR. FIREWALL IN MESH SULATION/SOUND I I H GRADING AL INSPECTION G CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL