The URL can be used to link to this page

002541 (SOTB)�lIIIIIIIIIIIIIIIIIIIIIIIII 17 Building 7_752 �� 52 Address Owner T P.O. BOX 1504 NO'.: 00 41 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address.., 1€� City `Zip Tel. La. '*a 92253564--€30144 Contractor Address City Zip Tela State Lic. �`"� City & Classif. 413636 Lic. It 133 Arch.; Engr.,.• _. ' Designer Address Tel. City Zip State _... Plumbing Lic. # LICENSED, CONTRACTOR'S. DECLARATION I hereby that I licensed of affirm am under provisions Chapte 9 (commencing'with Section 7000) of Division 3 ofAhe-Business andd''Professions Code, ani mmy license is in full force and ..effect.,.�� -.-✓ SIGNATURE:' ..! 67YP'DATE OWNER -BUILDER DECLARATION 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 BUILDING: TYPE CONST. OCC.:GRP. ' A.P. Number Legal Description Project Description Golz" New I4 Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation • �. ��p3.J3,•i!0 permit to construct, after, improve, demolish, or repair any structure, prior to its issuancealso 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).'. - 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; Buisness and'- Professions ,Code: The Contractor's License Law does not apply to an owner of property who PERMIT - AMOUNT . ' PIan.Chk. Dep.. 100.0 Plan Chk. Bal. j.�3•58 p Const. Sq. Ft. Size 6060No. 1. . . Stories No. Dw. Units New I4 Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation • �. ��p3.J3,•i!0 permit to construct, after, improve, demolish, or repair any structure, prior to its issuancealso 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).'. - 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; Buisness and'- Professions ,Code: The Contractor's License Law does not apply to an owner of property who PERMIT - AMOUNT . ' PIan.Chk. Dep.. 100.0 Plan Chk. Bal. j.�3•58 p Const. C 565 50 • Mech . •a�,�10 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 Electrical �- 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.)' Plumbing O I, as owner of the property, am exclusively contracting with licensed contractors to con- Strutt the project. (Seca 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. 8 P:C. for this reason - "i S.M.I. Grading - _ Driveway Enc.*** Date, Owner Infrastructures 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 O Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL L261.14 7.261 74 REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE. ' (This section need not be completed if the permit is for one hundred dollars ($100)' valuation or less.)• I certify that in•lhe performance of thg work for which this permit is issued, l 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. - ZONE: BY: Minimum Setback Distances: - ' Front.Setback from Center Line ' Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY hereby affirm that th'eie is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097; Civil Code.) Side Street Setback from .Center Line - Side Setback from Property Line Lender's Name FINAL DATE Issued by:. - Validated by: Validation: A6216 INSPECTOR Date R-16 f0ermit 8 19 7"263.76 Ci, 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] 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 -totenter the .above-. mentioned property for inspection purposes./ ttt�� t y/ jl r Signature of applicant r't sr9_�.✓�tpate.fp Mailing Address +' �r .< r r i City, State, Zip r r r HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. p FOR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. SO. FT. ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROUGYT PLUMB.(, 261 FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GA GH)/O 0 !/ LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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. ® c BATH TUB WATER SYSTEM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/4c HOUSE SEWER FINAL INSP. OOFING/r.�� 01 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 y�Y GROpp� DD P 91BIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADEy ROUGYT PLUMB.(, 261 BONDING HEATING (ROUGH) STORAGE TANK FORMS ��114 K /j /% v v/J SEWER OR SE v / GH WIRING DUCT WORK ROCK STORAGE FOUND. REINF.,�y !/ GA GH)/O 0 !/ 11 METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) vd// TF6kt-POLE 2"1� GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM � WATER SYSTEM GRADING CU. yd. $ plus x$ _$ LUMBER GR. L SP./Z//`/ ING ��% FINAL INSP. OOFING/r.�� 01 � REMARKS: REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL RING 1D MESH SULATION/SOUND %O / FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS, �- GARDEN WALL FINAL