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13076 (PAT)P.O. BOX 1504 Buildin78-105 CALLE ESTADO Address 44-870 Seeley Drive CA QUINTA,* CALIFORNIA 92253 Owner IdIIII111L Tom Ploufee M`1=1 AdTeS_S Same City. Zip Tel. La.Quinta# CAI -92253 1 Contractor Patrick J. Buggy Address - :40 -687 Schafer Place City lZip Tel.: alts Desert, (FA 92260 772'3989 .. -State Lic. City & passif Lic _. �� 3- 1 642953 2569 1'.Arch:,°Engr., .,Desiqner Address Tel. I Zip State Lic. # Hereby LICENSED CONTRACTOR'S DECLARATION.. reby affirm that I am licensed under provisions of Chapter 9 (commencing with Section A7000 )0 I Division 3 of,the Business and Professions Code, and my license is in full force and -effec SIGNATUREz —DATE ./OWNER -BUILDER DECLARATION Thereby affirm that I'am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or1county 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 role 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'-Bdsiness 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 sub'theapplicant to a civil penalty of not more than five hundred dollars ($500). the property, or my employees with wages as their sole compensation, will dol rnkerand the structure is not intended or offered for sale. (Sec. 7044, Buisness and Prole f, 6F ons I Pro ons 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 thar 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.) 0 -17, as owner of the property, am exclusively contracting with licensed contractors to con- str661-the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law doeSinot apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractor's License Law.) b I am exempt under Sec. B. & P.C. for this reason No. 13076 BUILDING: TYPE CONST._OCC: GRP_ A.P. Number LegalDescription Project Description'- Patio shadie cover witli walk- out -deck and railings Sq. Ft. No, Size`Stories New 0 Add 0 Alter 0 ;"No: 6va 'Units Repair 0 Demolition 0 Data Owner Infrastructure 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 I . . 0 Copy is filed with the city. 0 Certified copy is hereby furnished.. .. *4 , % .. 'k . gam. 39 tTOTAL _T�171 71 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Estimated Valuation S-4,31019..20.- • PERMIT AMOUNT Plan Chk. Dep. ZONE: BY: -Minimum Setback Distances: Front Setback from Center Line Plan Chk. Bal. A6.80 Const. 73.92 Mech. Lender's Address This is a building permit when properly filled out, signed and validated, and is sub�-ectft exp thereunderV I that I have read this application and state that the above information is correct. I a d state laws relating to building c on this city to enter the above-. m a Electrical Plumbing Validation: S.M.I. .50 Grading Driveway Enc Data Owner Infrastructure 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 I . . 0 Copy is filed with the city. 0 Certified copy is hereby furnished.. .. *4 , % .. 'k . gam. 39 tTOTAL _T�171 71 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (This section need not be completed if the permit is for one hundred dollars (S100) yaluation or less.) Y 1 certify that in the performance of thp work for which this permit is issued, I shall not employ anrson in any manner so as,to becom su ject to the Workers' Compensation 4Laws of-ali California, Datef, /<O.ner NOTICEIT01'A'PPLICANT: If,after-making'this C6rtificate of fiemption Pou should become subject to 'the Workers' Compensation"provisions of the pabor Code,, you must forthwith comply with such provisions or this perm�t_shafi be deemed revoked. 7 ZONE: BY: -Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line 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 Nam Side Street Setback from Center Line Side Setback from Property Line FINAL DATE -INSPECTOR i Issued by: Date Permit Validated by: Lender's Address This is a building permit when properly filled out, signed and validated, and is sub�-ectft exp thereunderV I that I have read this application and state that the above information is correct. I a d state laws relating to building c on this city to enter the above-. m a Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM FOR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SD. FT. GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN SO FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM REMARKS: 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 SQ. FT.® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 % c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac 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 PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TAN-- ANKFORMS FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. 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. FRAMING FINAL INSP. ROOFING /� '•� / � ��,�.I /f U [ Y�f � / �'�� /jam REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH I N SU LATI ONISOUN D FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL