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07193 (MFD5)Address 78-251 Scarlet Court Owner Boulevard Cev€l Twyl 4 4 Q" P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address 777 S. Main Street Sidi tin 106 City Zip Tel. Crane CA 9268 6 1 714-547-8856 Contractor Address Tela State Lic. I City & Classif. 461814 Lic. # Arch., Engr., Designer Address Tel. City (Zip ( State I Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 71100) of Division 3 -of the Business and Professions Code, and,my license is 'h full force and .Y 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, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile 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 rive 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 confractor(s) licensed pursuant to the Contractor's License Law.) O 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 NoCompany � . I-- s ,,.4 . O Copy is filed with the city. ❑ Cert fed copy is hereby furnished.--- CERTIFICATE urnished.---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 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, Civif 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. 1 car tity 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 No. 07133 BUILDING: TYPE CONST. _OCC: GRP. A.P. Number ,Legal Description Project Description 613-790-012 BLD #30 Unit #288 Plan X Sq. Ft.'� Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $56,886 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 289e289,909 Const. 446.00 Mech. 49.50 Electrical 62.67 Plumbing 94.550 S.M.I. 3.39 Grading Driveway Enc. Infrastructure 1,279.94 TOTAL $2,220.50 ,i.<.(.• _ ` REMARKS rPc; !s�t y e -+!t FyA 4<ti._4stt Sr ZONE: BY: Minimum Setback Distances: Fiont.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 2/21/90 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. @ BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. I SO. FT. GAS (FINAL) WALL SO. FT. ® DRINKING FOUNTAIN. GROUT URINAL SO FT ® SERVICE ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ plus x$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTOXDISH) APPLIANCE DRYER FINAL INSP. 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, 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 SO.FT.GAR ® V4c HOUSE SEWER 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 PLUMBINr/4" ELECTRICAL HEATING & AIR COND. SOLAR � SETBACK GROUND PLUMBI G of UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. �<aA �j©� V GAS (ROUGH) 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. FINAL INSP. FRAMINGS FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATH NG 6 ( 3 7 MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION'a QO C CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESlINITIALS ' GARDEN WALL FINAL