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BLCK (09209) + PAT (8100) + RPL (07864) + BLCK (07380)44465 Marigold Lane 09209 08100 07864 07380 44 P.O. BOX 1504 —~ No. 09209 Buildinge LA QUINTA CALIFORNIA92253 Address 44-465 Marigold Lan (lumcr Gill Roberge Mailing Address Saan, e City lZip Tel. Contractor i Pa? Address State Lic. City & Classif. C 29 B 455121 Lic. # 1812 Arch., Engr., - Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) ot,4ivision 3 of the`.Business and Professions Code, and my license is in full force and effect. 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":NAny city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement'that, he isolicensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing.wiih Section 7000) of Division 3 of the Business and Professions Code, or thathe 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). ❑ 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 • 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 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.) - ' 0 I, as owner of the property, am exclusively contracting with licensed contractors to con- 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner 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 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM 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 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. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Code.) - Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subjectto 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. 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. Signature of applicant Date Mailing Address City, State, Zip LDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description 114 1f of 61 block wall Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. . Grading _ Driveway Enc. Infrastructure TOTAL A ?1 REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line -Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. S0. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. I 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 FLOOR DRAIN MECHANICAL FEES A.C. UNIT WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER HEATING (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM DUCT WORK 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 GROUT SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL BOND BEAM a//C/A/ SO.FT.GAR ® 3/4c HOUSE SEWER GRADING cu. yd. $ plus x$ 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 l ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMSSEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCKSTORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM a//C/A/ Gb WATER SYSTEM GRADING cu. yd. $ plus x$ _$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING 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 Building Owner Mailing Address City Contractor Address d.. Zip ITel. ity lZip State Lic. City & Classif. Lic. # Arch., Engr., Designer Address Tel. 414 P.O. BOX 1504 No 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City( Zip I State Lic. # LICENSED CONTRACTOR'S 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. SIGNATURE 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 permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also 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 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 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.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- - 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 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. & P C. for this reason Date -</Ownerlpfi ✓ ✓ % s % •• 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 ❑ Copy Is filed with the city. ❑ Certified.copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. , Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date - Mailing Address City, State, Zip BUILDING: TYPE CONST. OCC: GRP. A.P. Number P Cactus Flower Legal Description Project Description Patin Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. A Const. Mech. Electrical Plumbing S.M.I. .$ Grading Driveway Enc. Infrastructure TOTAL $08.83 REMARKS 1104494 ig $454 061 A; 40 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE_ - INSPECTOR Issued by: Date 6/13/9OPermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO, FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SQ. FT. ®c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® lAc HOUSE SEWER VENTILATION 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 APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ 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 State Lic. & Classif. 421014 ' Arch., Engr., Designer Address Tit P.O. BOX 1504N O . O 78-105 CALLE ESTADO iaitgold LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC:,GRP. A.P. Number* Lacus Flow Zip Tel. 92253'2.. Legal Description Project Description R• Pel Sp m Road Zip Tel. 9M4 ...324'" ... City Lic. # `>-249 Sq. Ft. i No., - No. Dw. Size —Stories - Units New ❑ Add ❑ ,i. Alter ❑ Repair ❑ Demolition ❑ Tel. i City Zip State Lic. # LICENSED CONTRACTOR'S 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. r .; C='c1.r ., r, cF fe:. . r'-'ar' :1.r•li SIGNATURE,, • "' - - t (DAT ' `.J OWNER -BUILDER DECLARATION ! _ I hereby affirm that I am exempt from the Contractor's License law for the following Estimated Valuatl reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a on 2010W permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance also requires the applicant forsuch 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 • 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 N. Building 4:Address 44--; Owner ' Roberge ' Mailing' ,. Address Sate' . City 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 La Quints Contractor S.M.I. ' Sten Pool s Address t Driveway Enc. iif;;-'ZElF4' Vann State Lic. & Classif. 421014 ' Arch., Engr., Designer Address Tit P.O. BOX 1504N O . O 78-105 CALLE ESTADO iaitgold LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC:,GRP. A.P. Number* Lacus Flow Zip Tel. 92253'2.. Legal Description Project Description R• Pel Sp m Road Zip Tel. 9M4 ...324'" ... City Lic. # `>-249 Sq. Ft. i No., - No. Dw. Size —Stories - Units New ❑ Add ❑ ,i. Alter ❑ Repair ❑ Demolition ❑ Tel. i City Zip State Lic. # LICENSED CONTRACTOR'S 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. r .; C='c1.r ., r, cF fe:. . r'-'ar' :1.r•li SIGNATURE,, • "' - - t (DAT ' `.J OWNER -BUILDER DECLARATION ! _ I hereby affirm that I am exempt from the Contractor's License law for the following Estimated Valuatl reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a on 2010W permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance also requires the applicant forsuch 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 • 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 PERMIT `•.r AMOUNTu• , -- - -' Plan Chk. Dep. Plan Chk. Bal. Const. A L Mech. - - 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 r 27 Arl ❑ I, as owner of the property, im exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner or 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.) O 1 am exempt under Sec. B. & P.C. for this reason Grading Driveway Enc. Date Owner Infrastructure WORKERS' COMPENSATION DECLARATION 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.) r _ Policy No. Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. '• TOTAL _ • CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) 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. REMARKS .w+g.; :c`LSf3'L t"'•E't - '`" 't -isix'} - ` - Date Owner? " ZONE:- •- r BY: -' - - Minimum Setback Distances: 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: - . Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY 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 Street Setback from Center Line ^ Side Setback from Property Line ' Lender's Name FINAL DATE Issued by: -Validated by: • ' .• - . • - , INSPECTOR Date VV Permit 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.'8/9/\ I certify that I 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 to enter the above-. mentioned property for inspection purposes. Signature of applicant Date _ Mailing Address Validation: City, State, Zip tS 1-+ ++ a -r. •a<.+p } '„ . v r"v '+, 1"'r _. ; ^ " • 5+..: 5, `rg•' ti .. . i .. -:3 f,.r .. :t • .+.• .h l, ti. ,- '*e: „r`i, -.'-. r= - [Y -*v i r r e : ', -.`._ { t x`.Ali^ r •. ,.. .K.,7 •, ? -y.i, `r'^ . t a CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SO. FT. ® SQ 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 FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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. SQ. FT. ® c BATH TUB BOND BEAM SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1 Vi c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ec HOUSE SEWER FINAL INSP. ROOFING 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 ROUND PLUMBIN UNDERGROUN 7,0 -I 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. / S (ROUGH) ¢ D METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING FINAL INSP. ROOFING AAAOa NL'N aO / • O / REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION 7 O c CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL / P.O. BOX 1504 N o . Building WIOId LAtQUINTA8-105 C Address CAL FORNIA 92253 ` Owner _ Le. Quinta Assaclates Mailing BUILDING: -TYPE CONST. OCC: GRP. Address 43•-875 WAShint St. ♦ A.P. Number City Zip Tel. ...•. r iYTtae TaO"s' 33 P.. 3226€0 Legal Description Contractor .- 'lata 2A. Cactus Flower'. Esu.. Willi Pkv. C . Project Description Address ' Soria' i City Zip Tel.: State Lic. City 8 Classif.49391.4 Lic. # YZ I Arch:, Engr., r Designer It Sq. Ft.' No: No. Dw. .Size.. 121" `Stories Units New Z `Add O. - ' Alter p. Repair O ,Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION ' thereby 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 and r effect- 1 - SIGNATURE' DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 7031.5,Busfness Code: 87,514.00 ' (Sec. and Professions Any city or oounry which requires a permit to constructaHer, improve, demolish, or repair any structure, prior to its issuance also 41 - requires -the applicant for such pemn@ to fife a signed statement that he is licensed pursuant to ­PERMIT"r 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 ateged exemption. Any violation of Section 7031.5 by 'any applicant for a permit Plan Chk. Dep. ' subjects the applicant to a civil penally of not more than rive hundred dollars .(S500). OJ, the -. Plan Chk. Bal. 488-.77 as owner of 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 Const.. i a, ..Si Code: The Contractor's License Law does not apply to an owner of property who r,. builds or, improves thereon and who does such work himself or through his own employees, Mech, q 5-0,50 Provided that such improvements proveents are not intended or offered for safe. If, however, the building or improvement is sold within oneyear of completion, the owner -builder '"I have the burden Electrical 1t 4,• Qii .. of proving that he did not build or improve for the purpose of sale.) _ - • ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- -. Plumbing 123.00 struct the project. (Sec. 7044, Business and Professions Coder 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. • ', r 6.16 _ such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading • O 1 am exempt under Sec B. & P.C. for this reason Driveway Enc. r. Date owner Infrastructure 1969.7 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 r =O'Copy.is filed with the city. ❑ Certified copy is hereby furnished.. , ' TOTAL 3330.00 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS • = ^ (This section need not be completed if the permit is for one hundred dollars (5100) valuation - • . - ,'s,' Nr'1 •'L"f•= ? i Kj" FtJ' ,f;. . Yd z<i'E=a•. ifsilrJ ''t ' 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: t, after making this Certificate of `Exemption you should become ZONE: ' BY: ' • subject to the , Workers' Compensation provisions of the Labor Code, you must forthwith - campy 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 whicft this permit is issued. (Sec. 3097, Civil Code.) Side Setback from Property Line Lender's Name Lenders Address FINAL' DATE 4 ' 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 6-15" 9 application and state that the above information is correct. I agree to comply 'city = Issued by: - Dat Permit with all and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to -enter the above-. fi 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 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE 7 CD ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) % / / / ETER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) EMP. POLE DRAINAGE PIPING CAR P. SD.FT. GROUT WATER HEATER WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. URINAL SQ FT ® 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(AUTOXDISH) 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ic 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 /,,/LECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL AREA SLAB GRADE 7 CD ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. b 2 9 G GAS (ROUGH) % / / / ETER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL GAS (FINAL) EMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM LUMBER GR. FRAMING e® / << ROOFING Gt 6 VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL yy LATHING /J MESH INSULATIONISOUND (c)t i s Sffl FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL GARDEN WALL FINAL WATER SYSTEM FINAL INSP. P FINAL INSP. yd. $ plus x$ =$ REMARKS: P.O. BOX 1504 No. 07380 Building 78-105 44-455 Marigold Lane LA QUINTAC Address CALIFORNIA 92253 Owner • - - - - Gil Roberge BUILDING: TYPE CONST. OCC: GRP. Mailin Address 44-465 Marigold Lanae A.P. Number Cactus Flower CjtAy Quiazta Zi§29253 Tel. Legal Description Co tra ctor el.: State Lic.I City & Classif. Lic. If Arch., Engr., Designer Address I Tel. City (Zip ( State I Lic. # LICENSED CONTRACTOR'S 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. _SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason: (Sec- 7031.5,19tusimess and Professions Code: Any city or county which requires a permit to construct, after, hWrove, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions or 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 therelmm, 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). ❑ 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 taw does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such irnprovements, are not intended or offered for sale. If, however, the building or improvement is said within one year of corrpletion. the owner -budder will have the burden of proving that he did not build or inprove for the purpose or safe.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con. struct the project. (Sec- 7044, Bus -mess and Professions Code: The Contractor's License Law does not apply to an owner of property who braids or improves thereon, and who contracts for -such projects with a contractor(s) licensed pursuant to the Contractor's License Law-) O 1 am exempt under Sec B. & P;C. for this reason Date r ,f: Owner 'f WORKERS' COMPENSATION DECLARATION 1 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. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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 subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Ihereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lenders Name Lenders Address This is a building permit when property 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 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 to enter the above-. mentioned property for inspection purposes Signature of applicant Date Mailing Address City_ State, Zip Project Description 655 -foot x 153 -foot #arden wall Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Estimated Valuation $3,825 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal Const. W. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure A n TOTAL REMARKS t+ l 3 l,iI 4 e"63.20 y B f i. e•1'' ' ` x.Y, r r vj 17,7. 20 r .. ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop- Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE - INSPECTOR Issued by: Date 3/19/90Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. S0. FT. ® GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN. BOND BEAM WATER SYSTEM URINAL SO FT ® LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. 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 VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACE 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 ® 11/4 c SEWAGE DISPOSAL SO.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 cu. yd. $ -Plus-x$-=$ 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