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04586 (PLBG) IIIIIIIIVIIIIIIIIIIIIIII 33 4 IE , P.O. BOX 1504 Building' 4g° �78 � � 78-105 CALLE ESTADO Address LA QUINTA,CALIFORNIA 92253 Owner , Mailing Thompson BUILDING: TYPE CONST. OCC.GRP. Address -49-778 Avila A.P. Number City Zip Tel. La QtM�nta 9225 Legal Description Contractor Project Description Suet' Hook-up Eport© Sower se:rVice Address' �w F. 0. Box 192 CityZip Tel. Palm Desert l9226 - .3461-2793 State Lic. City - &Classif. 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 CONTRACTOR'S DECLARATION I hereby affirm het I am licensed.under provisions of Chapter 9(commencing with Section 7000)of Division3 of the.Business and Professions Code,and my license is in full force and effect.j�,p "f�;;a ..i t,S,4•- wo .-w., ,:,. +++.w ith;1,A" SIGNATURE �.� R SCS BATE OWNER-BUILDER DECLARATION Estimated Valuation I hereby.affirm;ihat,l am exempt from the Contractor's License Law for the following $400 reasom,:(Sec:,-703-TC5;Buslness and Professions Code: Any city or county which requires a _ permit,to',;construct-;aiter;simprove, demolish, or repair any structure, prior to its issuance also requires the;applicanG:lor such permit to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions�'o/=the CO'ntractor's License Law, Chapter 9 (commencing with Section 7000) o/ Division 3'o%.the Business and Professions Code, or thathe is exempt therefrom, and the basis .plan Chk. De for the alleged'exemption. Any violation of Section 7031.5 by 'any applicant for a permit p subjects the applicant to a civil penalty of 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,Bussness and Const. $20.00 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 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 Electrical of proving that he did not build or improve for the purpose o/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 builds or improves thereon, and who contracts for S.M,I. 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 Grading Driveway Enc. Date owner Infrastructure WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate�of orisent�to self-insure,or a certificate of Worker's Compensation Insurance,or a certified-o6yjt-hheer#eof.(Sec.3800,Labor Code.) Policy No. Company —T� ❑Copy is filed with the city. ❑Certified copy is he�eby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS '✓ WORKERS'COMPENSATION INSURANCE n This section need not be completed if the tor-11 WAS. N 9�UMVJI--Y—ld)i '20'+Ii)1 V ( p permit is for one hundred dollars (E 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: If, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions o/ the Labor Code, you must forthwith Minimum Setback Distances: comply with such provisions or this permit shall be deemed revoked. 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,Civil Code.) Side Setback from Property Line Lender's Name Lender's Address INSPECTOR This is a building permit when properly filled out,signed and validated,and Is subject to FINAL DATE T expiration it work thereunder is suspended for 180 days. 9/19/88, 1 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 WHITE-FINANCE,PINK-APPLICANT,GREEN-BUILDING,GOLDENROD-_ASSESSOR'S OFFICE,HARD COPY-6FILE , �.�,. •.. ........ _. ,._ b. -.._. __. .. .. r...- nr> .. vr... ...r ., .... _. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT IA $ UNITS YARD SPKLR SYSTEM 2ND FL SO FT.a POR SO FTat MOBILEHOME SVC. BAR SINK GAR SO.FT.(a POWER OUTLET ROOF DRAINS CAR P. SO FT.a DRAINAGE PIPING WALLSO.FT.@ DRINKING FOUNTAIN SO.FT. URINAL (a 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 WASH ER(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,TEMIPERM 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 T%c SEWAGE DISPOSAL SO.FT.GAR re 3/4c HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE 11PL.CK.FEE CONST.FEE ELECT.FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C.UNIT COLL.AREA SLAB GRADE ROUGH PLUMB BONDING HEATING(ROUGH) STORAGE TANK FORMSEWER OR SEPTIC TA ROUGH WIRING DUCT WORK ROCK STORAGE FOUND.REINF. GAS(ROUGH) METER LOOP HEATING(FINAL) OTHER APP.IEOUIP. 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. $ plu5 x$ =$ ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL