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07178 (MFD5)Building Address 78-327 Scarletet Cour Owner Boulevard Develowen T- i ty 4 4 a" P.O. BOX 1504 713105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address 777 S. ftin Street Suite 1€ 6 City Zip Tel. Orange CA 1 92686 714-547-8056 Contractor . Same Address Zip JTel.- State Lic. I City & Classif. 461814 Lic. # Arch., Engr., Designer Address Tel. City IZIp ISL to LICENSED CONTRACTOR'S DECLARATION I hereby affirm that`t ilii licensed under provisions of Chapter 9 (commencing with Section 70001 of<bivision adfAhe Professions Business and Pessions Code, and fury li se is in full force and q• effect ��� i •i 1 ice. /. -, � 3/.� r/ OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason_ (Sec. 7031.5,8usiness and Professions Code: Any city or county which requires a permit to constructatter, krprove, demoish'or repair any structure, prior to its issuance also requires the appfcarm for such permit to ft signed statement that hes licensed pursuant to the provisions of the Contractors License Law, Chapter 9 (carmrena ng with Section 7000) of Dhisiori 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exemption. Any violation or section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dog= ($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 Professions Code: The Contractor's License Law does not appy to an owner of property who builds or improves thereon and who does such work himself or through his own employees, Provided that such krprovements are no intended or offered for sale. If, however, the building of improvement is sold within one year of completion, the owner-buMder wig have the burden of proving that he did not build or improve 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 appy to an owner of property who builds or krproves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractors License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason Date owner WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate 'of'consent•to self -insure, or a certificate of Worker's Compensation Insurance, or'a'cerfified copy thereof. (sec. 3800, Labor Code.) Policy No Company._ ��i !i - 21 - /-r .rL,-_'_' ❑ Copy is filed with the city. ❑ "fied co� hereby furnished. , CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sermon need not be completed if the permit is for one hundred dollars (E100) valuation or less.) certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California Date Owner NOTLCE TO APPLICANT ff, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith coney 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, Cin? 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. 1 certify 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. 07.78 JILDING: TYPE CONST. a OCC: GRP. - P. Number 613-7'90-013 Description BLD M Unit f250 Project Description Plar. 3U 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 2/21/90 Permit Validated by: Validation: Sq. Ft'76.E Size No. Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $58,886 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. on 289. ,. Const. 446.00 Mech. 49 50 Electrical 62.67 Plumbing 94.50 S.M.I. 3.99 Grading Driveway Enc. Infrastructure 1,279.94 TOTAL $ a . Q; iZ,T ._:% s -/7' REMARKS 4A 7127 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 2/21/90 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE S/Z//QG/� YARD SPKLR SYSTEM 2ND FL. SO. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. ` DRAINAGE PIPING CAR P. SO. FT. ® HEATING (FINAL) WALL SO. FT. ® REINF. STEEL DRINKING FOUNTAIN SO FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LUMBER GR. LAUNDRYTRAY AIR HANDLING UNIT CFM FRAMING 'z l( Cv 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SO.FT.GAR ® 114c k HOUSE SEWER SPARK ARRESTOR —1 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 SETBACK GROUND PLUMBING © UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE S/Z//QG/� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. ` 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. D FRAMING 'z l( Cv FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ING MESH INSULATIONISOUND'7�� �Ja [[[ c FINISH GRADING FINAL INSPECTION 2 a CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS ' GARDEN WALL FINAL