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RR (10388)51680 Avenida Madero 10388 T4hf 4 4 aubt! P.O. BOX 1504 ! L No. 10388 Building `' l 1 a _ 78.105 CALLS ESTADO Address -' " ` 1' ' LA QUINTA, CALIFORNIA 82253 Owner e7 Malting BUILDING: TYPE CONST. OCC. GRP. Address Sz1.'i A.P. Number City Zip Tel. 53 Legal Description Contractor res 0.;- j .rj Project Description ..'00 ;_ Address City lzi, Tel. 201 3rd .. ii;u State Lic. City & Classif. ("`;3 9 3 ; 2 0 0 ; Lic. # 3 1 Sq. Ft. No. No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSEDCONY.RACTOR'S DECLARATION harshy affirm•.that I am Iioerlsed un er provisions of Chapter 9 (commencing with Section 7000) of Dlvit ion 3 of the Btt&was an Professions Code, and my license is in full force and effect: . SIGNATURE -DATE awkER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation re reason: tSec. 7031.5,13uslness and Professions Code: Any city or county which requires a i 8 2 `= ` • i permll to aonstrucl, alter, Improve, demolish, or repair any seuclute, prior to its issuance also requires the applicanf for such permit to fila a signed statement that he is. licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's license Law, Chapter S (commencing with Seclka 7000) of Dvision 3 of rhe Business and Professions Code, or that he Is exempt therefrom, and the basis for the alleged exemptton. Any obiauon of Section 7031.5 by any applicant for a parmH Plan Chk. Dep. subjects fha applicani to a civ$ penalty of not mora than five hundred do$ars ($500). ❑ t, as owner of the property, or my empioyees with wages as their sole compensation, win Plan Chk. Bal. do the work, and the structure is not intended or offered for sale. (Sec. 7044, But5ness and Const. Coda: The Contractors License Law dues not apply to an owner of properly who builds or khproves theraen and who does such work himsell at through his own employees. Mech. provided that such Improvements are not Intended or offered for sale. If, however, rho b uluft or Improvement is surd wilhln one year of completion, the owner-buiWL-r wla have the burden Electrical of pioving 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 Cade: 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 contractors) 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 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 _ i} Copy is filed with the city. ❑ Cerllfied copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS 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 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 Cal 1Forn,a. Date Owner NOTICE TO APPLICANT: If, &nor making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of 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 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. I certify that I have read this application and slate that the above information is cafrevL Issued by: Date Permit I agree to comply witty all city and county ordinances and state laws relating to building constructlon, and hereby authorize representatives -of this city to enter the above- mentioned properly for inspection purposes. Validated by: Signature of applicant— Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL SO. FT. ® POR. SO. FT. GAR. SQ. FT. ® CAR P. SO. FT. ® WALL SQ. FT. ® SO. FT. 0 ESTIMATED CONSTRUCTION VALUATION E UNITS MOBILEHOME SVC. POWER OUTLET I SLAB GRADE YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation ROCK STORAGE FLOOR DRAIN MECHANICAL FEES METER LOOP WATER SOFTENER VENT SYSTEM FAN EVAP_COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED WATER HEATER 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 REMARKS: SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ic HOUSE SEWER FIREPLACE GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.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 APP./EQUIP. REIN F. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. ; plus xa =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING 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