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07164 (MFD5)Building Address 78_261 Scarlet Count Owner Boulevard Develoment P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address 777 S. Main Street Suite 106 City Zip Tel Orange CA 92686 734-547-8056 Contractor aw Address . City IZip I Tela State Lic. City & Classif.461814 I Lic. # Designers ' Address Tel. City IZip ( State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of irfsion.3 of the Business and Professions Code, and my license is in full force and effect "+ - SIGNATURE✓ - _ '. x.•^ DATE 'y OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reasOrr (Sec. 7031.5,0sness and Rolessions Code: Any city or county which requires a Pem* to eonstnict. alter, inprove, demolish, or repair any structure, prior to its issuance also requires the appfcant for such permit to fie a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of OivLtion 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 One appNica f to a ch4 penally of nal more than five hundred dollars ($500). ❑ 1, 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 Prolessians Code: The Co Merinos License Law does not apply to an owner of property who builds orrrproves thereon and who does such work himself or through his own employees, provided that such wprovernents are not intended or offered for sale. If, however, the building or 6rpmvernent is sold within one year of completion, the owner -budder will have the burden of proving that he did not brad or irprove for the purpose of sale.) ❑ 1, 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 odds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Ser~ B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION Jr fa�t I hereby affirm that 1 have a.certificate of consent to self•insure or a certificate of Worker s Compensation Insurance, ora certified copy thereof. (Sec. 3800; Labor, CoM) Policy No Companys'�"_. ,r * ..f,. %,r 11Copy 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 ($1 oo) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia bate Owner NOTICE TO APPLICANT: 9, after making Otis Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith campy wih such provisions or this pemnit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Cin? Code.) Lender's Nano: Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certily that I have read this application and state that the above information is correct. I'agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City,. State, Zip No. 07164 UILDING: TYPE CONST. OCC: GRP.m .P. Number 613-790-012 egal Description BLD #29 Unit 1283 roject Description Plan 2U Sq. Ft. 912 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Estimated Valuation E�36lt226 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. a �• �_ Const. Mech. Electrical 0. Plumbing M. ru S.M.I. . 4• G2 Grading Driveway Enc. p Infrastructure • ��i�_ TOTAL y.lVei..r6i c`.1 REMARKS rw;,arV3 ..n, � :i or -A -40-0.`i, i,'i J$i f -flfi fi 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: 2121190 Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL. AREA SLAB GRADE �� f� ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL SO. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR SO FT @ DUCT WORK ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) DRAINAGE PIPING CAR P. I SO. FT. ® GAS (FINAL) TEMP. POLE WALL SO. FT. DRINKING FOUNTAIN. FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. 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(AUTO)(DISH) APPLIANCE DRYER ROOFING 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, TEfv /PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SO. FT. ® c BATH TUB SO. FT. ® cWATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/. cRELECT.FEE SEWAGE DISPOSAL SO.FT.GAR ® 3/acHOUSE SEWER MESH GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE �� f� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. /f04 l/ 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. LD FRAMING I& lll�� FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ZING y S O MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION B L CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL