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05015 (SFD)1 4 4 " P.O. BOX 1504 Building Address 55-069.69 Riviera LA QUINTA, CALIFORNIA 92253 Owner Mailing ' Address 42-600 C*ok Street, Suit`4 ,.200 City Zip Tel. sa1-rd Vdaert 92260 565-2529 Contractor Address Zip I Tel. State Lic. City & Classif. 288130 Lic. # 329 Designer Address Tel. City (Zip ( State Lic. # r 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,Business and Professions Code: Any city or county which requires a permit to construct, atter, 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 atteged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a cAdl penalty of not more than rove 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 Contractors 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 linprove for the purpose of sale.) O 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 contractorfs) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. R. & 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 ff 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. Date Owner NOTICE TO APPLICANT. H, 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 property 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. 1 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 ateMailing Address City, State, Zip No. 05015 BUILDING:. TYPE CONST. OCC: GRP. A.P.. Number.. PGA West Phase 2PC Legal Description Project Description Pisa P2A 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 12120/88 Issued by: Date Permit Validated by: Validation: Sq. Ft. Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation fi ion PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. S 536.00 Const. 660. 5 Q Mech. 39.00 Electrical 99.61 Plumbing 114.00 S.M.I. 13-37 Grading Driveway Enc. Infrastructure $4.275.05 2..137.53 a..Cro-dit 2.1-17.53 TOTAL 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 12120/88 Issued by: Date Permit Validated by: Validation: ILC CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES - 1ST FL. SQ. FT. ® $ UNITS V ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK YARD SPKLR SYSTEM 2N0 FL SQ. FT. DUCT WORK ROCK STORAGE aiLIND. REINF_5 7 �� G- MOBILEHOME SVC. BAR SINK POR. SQ, FT. ® REINF. STEEL AS (FINAL) TEMP. POLE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS WATER HEATER ICE D FINAL INSP. DRAINAGE PIPING CAR P. SQ. FT. WATER SYSTEM GRADING CU. yd. $ -plus-x$-=$ WALL SQ. FT. LUMBER GR. DRINKING FOUNTAIN. SQ FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ 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(AUTOXDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED SPARK ARRESTOR LAUNDRY TRAY AIR HANDLING UNIT CFM GAR. FIREWALL 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 FIIJOH GRADING SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.'.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TO -AL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK OLIND PLUMBING5--��• UNDERGROUND A.C. UNIT COLL. AREA GRADE V ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS ER OR SEPTI ROUGH WIRING DUCT WORK ROCK STORAGE aiLIND. REINF_5 7 �� G- G - OUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL AS (FINAL) TEMP. POLE GROUT WATER HEATER ICE D FINAL INSP. BOND BEAM WATER SYSTEM GRADING CU. yd. $ -plus-x$-=$ LUMBER GR. FINAL INSP. FINAL INSP. EMI NG VENTILATION �� ,p Q� ��/ REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING M SH i INSULATION/SOUND FIIJOH GRADING NAL INSPECTION L CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESJINITIALS GARDEN WALL FINAL 1