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13-0363 (MECH)IIIIiII 11111 111 lliil 1111 52 �Gv IE 4- P.O. BOX 1504 N o . Building 78-105 CALLE ESTADO Address 78 -WS Aldw Circle. LA QUINTA, CALIFORNIA 92253 Acacia s Mailing Address 1021 W. Plastafthury Rnad City Zip Tel. Contractor Aaaress City Zip Tela State Lic. & Classif.tj!` Al— City Lic. # Arch., Engr., Designer Address Tel. ' City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that l am licensed unde '"rovisjons of Chapter 9 (commencing with Section 7000) of Dlvisiom3:of the Bu ness nd �rofea.sions Code, and my license is in full force and effect: _� DATE w OWNER -BUILDER DECLARATION Irhereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, 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 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 five hundred dollars ($500). 0 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 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I 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 No. Company [Ropy is filed with the city. ❑ Certified copy is hereby furnished. ��!! 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, Civil 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. I certify that I have read this application and stale 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 JILDING: TYPE CONST. OCC: GRP. P. Number Acacia Homs 07817 Legal Description Tract I—W9 t Plan A-2 R00., Project Description Lot 105 Sq. Ft. No. ' No. Dw. Size 1362 Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation E3 PERMIT AMOUNT Plan Chk: Dep. '• Plan Chk. Bal. 441.34 Const. 527.00 Mech. 47.00 Electrical 90.61 Plumbing 120,650 S.M.I. 6.25 Grading Driveway Enc. Infrastructure 1679.19 TOTAL 2,910.89 REMARKS iiAv;-t1P_'1 Ah 427- .�5^:a%•�7'"�Q ltd ^r -j if i. .ii t Il t ;. t lr7,n. Y 4. r 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 5/4/90Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT 2ND FL. SQ. FT. SLAB GRADE PARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS SEWER OR SEPTIC TANK ROUGH WIRING. DRAINAGE PIPING CAR P. SQ. FT. DUCT WORK ROCK STORAGE WALL SQ. FT. GAS (ROUGH) DRINKING FOUNTAIN. SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ REINF. STEEL 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(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED WATER SYSTEM LAUNDRY TRAY AIR HANDLING UNIT CFM I 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 VENTILATION SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL MESH SQ.FT.GAR ® VAc HOUSE SEWER FINAL INSPECTION CERT. OCC. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE IPL.CK.FEE CONST. FEE !EL!ECT.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 TANK 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 yd. plus x$ =$ LUMBER GR. FINAL INSP-?0/ Scu. RAMING_ FINAL INSP. / l ROOFING !V x Z? �D ��� ��' LL/ �L��>� (, Y� �\ 9 v GC REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH I SULATIONISOUNDI�F-- FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL 1111111 VIII III VIII IIII 53 IE Address 78_605 ALDEN ',Address Owner STEVE TIFF? Mailing Address 78-605 ALDEN c&ty/ 4 n P.O. BOX 1504 N o . 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 {� } CityZip Tel. LA QUINTA: CE 92253 1568-6184 Contractor OWNER BUILDER Zip I'Tel.: State Lic.I City & Classif. Lic. # Arch., Engr., Designer Address city I ZipI State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) t. of Division 3 of the Business and Professions Code, and my license is in full force and effec _SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirin 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 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 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 five hundred dollars (8500). O 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, Bulsness 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.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the on- structthe project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of propertywhobuilds 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 Sec._,,.===.,__B. & P.C. for this reason VDate a.'! . rJf Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers 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 if the permit is for one hundred dollars (8100) valuation or less.) I certify that in the performance of the 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: lf,­aftei 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=firm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) . Lenders Name Lenders Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. ' I 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 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Description .t Description POOL AND SPA r REMARKS* r- r 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 Permit 1 Validated by: Validation: Sq. Ft. No. Size Stories No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ 'Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $ 0,2 Const. 108.00 Mech. L .00 Electrical "' 45.00 Plumbing 27.00 S.M.L� .90 Grading Driveway Enc. Infrastructure TOTAL $ Z S . O REMARKS* r- r 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 Permit 1 Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. 0 $ UNITS A.C. UNIT 2ND FL SQ. FT. SLAB GRADE YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. POWER OUTLET ROOF DRAINS CAR P. SQ. FT. @ SEWER OR SEPTIC TANK DRAINAGE PIPING WALL SQ. FT. DUCT WORK DRINKING FOUNTAIN. SQ FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation REINF. STEEL FLOOR DRAIN MECHANICAL FEES TEMP. POLE WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WATER HEATER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM 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. a c BATH TUB N, 1, l," C-�q ✓ [ �-'/ l REMARKS: SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1Y4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FIREPLACE 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-;N'll G NDERGROUND d QC, 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. GAS (ROUGH) L 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. C�'( FRAMING ! FINAL INSP. / /LV l l / ROOFING N, 1, l," C-�q ✓ [ �-'/ REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL 4 U��ciGV P.O. Sox IN4 76105 CALLE ESTADO s LA OUINTA. CALIFORNIA 92257 Contractor Owner m -C Address Job Address's #- C,t-&y La Quinta City License No.: Expires: Bldg. Permit No.: This form shall be posted on the job with the Building Inspection Card and it shall be the duty of the General Contractor or if Owner -Builder Permit, the owner to see that all sub -contractors sign this card, giving his City of La Quint& Business License Number, Contractors License Number and a current certificate of Workman's Compensation Insurance Certificate when he starts the job. Failure to comply may cause Building Inspectors to stop work, or complaints to be filed against such contractors or owners. CITY CONT. SUB -CONTRACTORS NAME LIC. NO. EXPIRES LIC. NO. EXPIRES 1. Grade i Excavate C 2. Pipelines 3. Cement -Foundations Se 4. Cement Walks i Drives 5. Asphalt Paving 6. Framing 7. Steel Structural 8. Masonry 9. Plumbing Lathing Ll. Drywall L2. Plastering I v� 13. HVAC vear I L4. Electrical L5. Roofing L6. Sheet Metal 17. Floors -All Types 18. Glass - Glazing 19. Insulation/Weatherstrip 20. Sewage Disposal 21. Painting/Decorating 22. Tile 2 23. Cabinets -Installations 24. Ornamental Metal 25. Fences/Blockwalls 26. Landscaping nn tr /� 27. Othe,xs `i` F� MAI rQV� � �_ • /�%9S DO NOT REMOVE THIS CARD Before Final Building Inspection Will Be Made This Form Must Be Completed and Filed With Title 24 Calcs and Plans