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05548 (PLBG) IIIIIII VIII III VIII IIII 424 IE P.O. BOX 1504 No. 05548 Building �9�� 78-105 CALLE ESTADO Address LA QUINTA,CALIFORNIA 92253 Owner ls. VarelaMailing BUILDING: TYPE CONST. OCC:GRP. Address A.P.Number Coif Estates city LaQuinta Zip922 53 Tel. Legal Description Contractor Econo Sever Service Project Description Seil+Cx' IIOOlttp Address PLO. Box 192 CityPalm Desert ZIp922b1 Tb19/ 34 2793 State Lic. City &Classif. C-42 480961 Lic.#342 Sq.Ft. No. No. DW. Arch.,Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic.# ( LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3,of the Business and Professions Code,and my license is in full force and effect.,_,- S)GNATURE `,..•:—_.'t DATE OWNER-BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following $300.00 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, after, inprove, demolish, or repair any structure, prior to its issuance also AMOUNT requires the applicant for such permit to ft a signed statement that he is licensed pursuant to PERMIT the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of grvision 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 Plan Chk. Dep. subjects the applicant to a civil penally o/not more than five hundred dollars($500). ❑I,as owner of the property,or my employees with wages as their sole compensation,will Plan Chk. Bal. do the work,and the structure is not intended or offered for sale.(Sec. 7044,Buisness and Const. 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, Mech. provided that srouch improvements are not intended or offered for sale. g, however, the building or improvement is sold withinone year of corpletion, the owner-builder will have the burden Electrical 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- Plumbing struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who bum7ds or improves thereon, and who contracts for S.M.I. • such projects with a contractor(s)licensed pursuant to the Contractor's License Law.) Grading ❑I am exempt under Sec. a,&P.C.for this reason Driveway Enc. Date owner Infrastructure WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent-tp self-insure, or a certificate of Worker*s Compensation Insurance,or a certifie4,copy thereof.(sec.3800,Labor Code.) Policy No. Company �"'� '�* 1, ❑Copy is filed with the city. ❑Certified copy is here ,,,,ttff by mished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS .r�ms *4s.;tc{YNI WORKERS'COMPENSATION INSURANCE _ - (This section need not be completed ff the pemrt is for one hundred dollars ($100) 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: ff. after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such Provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CivdCode.) Side Setback from Property Line Lender's Name Lenders Address FINAL DATE INSPECTOR This is a building permit when properly filled out,signed and validated,and is subject to FINAL expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. Issued by: Date Permit 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. Validated by: Signature of applicant_ Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ.FT.® $ UNITS YARD SPKLR SYSTEM 2ND FL. SO.FT. POR. SQ.FT.® MOBILEHOME SVC. BAR SINK GAR. SO.FT.® POWER OUTLET ROOF DRAINS CAR P. I SQ.FT.® DRAINAGE PIPING WALL SQ.FT. DRINKING FOUNTAIN. SQ.FT.@ URINAL ESTIMATED CONSTRUCTION VALUATION $ 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 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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. SQ.FT.®c BATH TUB SO.FT.®c WATER HEATER MAX.HEATER OUTPUT,B.T.U. SO.FT.RESID a 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 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 LUMBER GR. FINAL INSP. cu.yd. FRAMING FINAL INSP. Q $-Plus-X$-=$ ROOFING y REMARKS: VENTILATION (/ FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL' 1