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04598 (PLBG) I��II�I�����IIS VIII III 27 4 �� �, - IE 4598 P.O. BOX 1504 Building'' . 49-754 AVila 78-105 CALLE ESTADO Address - LA QUINTA,CALIFORNIA 92253 Owner s Mailing ' y BUILDING: TYPE CONST. OCC.GRP. Address A.P. Number O/A* Ar> .:t ? lj 7jw 1&'A City Zip Tel. La pinta M53 Legal Description Contractor Project Description Sewer hook-1-113 Scono 'Sewc'r Service Address P. 04 BOX 192 ,..t City Zip Tel. f�aU4 Desert 92261 ��r�1�-�99� State Lic. City ,r i£Classif. 484962 Lic.# "142 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 that I am lice"'ed 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. f ' )h,4A e SIGNATURE 'k 'DATE OWNkR•BUILDER DECLARATION Estimated Valuation I hereby affirm 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 fide a signed statement that he is licensed pursuant to PERMIT AMOUNT 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 Plan Chk. Dep. - subjects the applicant to a civil penalty of not more than five hundred dollars($500). O 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,auisness and Const. ff 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-bulkier will have the burden Electrical ' of proving that he did not build or improve for the purpose of sale.) i O 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.1. such projects with a contractor(s)licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. B.&P.C.for this reason Driveway Enc. Date Owner Infrastructure WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificatekof copse'pt to self-insure,or a certificate of Worker's Compensation Insurance,or a certifie&copy thereof.(Sec.3800,Labor Code.) Policy No. Company v �''�+ ❑Copy is filed with the city. O Certified cop yzis-hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATION INSURANCE 1 1 rf (This section need not be completed if the permit is for one hundred dollars ($100) valuation ,j*-444 fkes ti,§;X `�`4'�" �►,'4 nr }. 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 of the Labor Code, you must forthwith MlnimUln 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 FINAL DATE INSPECTOR 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. 9/26/8a 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 WHITE-FINANCE,PINK-APPLICANT,GREEN-BUILDING,GOL0ENf100•ASSESSOR'S OFFICE,HARD COPY-FILE CONSTRUCTION ESTIMATL NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT rp 3 UNITS YARD SPKLR SYSTEM 2ND FL SO FT.at POR SO FT.Qt MOBILEHOME SVC. BAR SINK GAR SO.FT.* POWER OUTLET ROOF DRAINS DRAINAGE PIPING CAR P. SO FT. WALL SO.FT.Q1 DRINKING FOUNTAIN URINAL SO.FT.p3 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)(DISHI APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY 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 114 c SEWAGE DISPOSAL SO.FT.GAR rg 3i4c 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 8 AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C.UNIT COLL.AREA SLAB GRADE ROUGH PLUMB BONDING HEATING(ROUGH) STORAGE TANK FORMS EWER OR SEP _ ROUGH WIRING DUCT WORK ROCK STORAGE FOUND.REINF. GAS(ROUGH) o� 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. $_plus_x$ _$ REMARKS: ROOFING VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR' GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING INAL INSPECTION9��— CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL