MISC (05906)79590 Marigold Lane
05906
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' Ow
REMARKS ikvtiY. tlrElms- Y15(4 it9R s',ii +7GFF 4 t
ner
NOTICE TO APPLICANT: 11, after, making this Certificate of Exemption you should become
ZONE:
BY: '>
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith-
:Comply With Such provisions orthspemr8Shall bedeemed revoked.
Minimum Setback Distances: -
Front Setback from Center. Line
P.O. BOX 1504 f No.
-,05906
Building 78-105 CALLE ESTADO
- Address 79-530 Marigold pLeme _ LA QUINTA, CALIFORNIA 92253
_
`
Owner
-
LA 04uta Associate
Side Setback from Property Line -
-n ..
' Mailing
BUILDING:4TYPE CONST.' OCC:
GRP.*
Address 43-875 Washiugt's St.,
FINAL.DATE
'
INSPECTOR
This is a building permit when properly filled out, signed and validated, and is'subject to
A.P:•Numberj • l-'
6-15-89.
I certity that I have read this application and state that the above information is correct:.
Tel.
Date Permit
I agree to comply with all city and county ordinances and state laws relating to building '
-CityZip
P.D.
92260
.,x
Legal Description Phe -Se. It Lot 3} -
-
Contractor
Project Description Pian 4AR
Cactis Fx••oyei
1,G- Williams Dev. Corp.
-
Address . _
V811datlOn:
„ ..
City, State, Zip
835£"
City
Zip
Tela
State Lic.
& Classif. i 3 1
City
Lic. # 123 .,,, _.., s
Sq. Ft. y No.
,
No. Dw.'
Arch., Engr.,
Size87 Stories
Units -
Designer,
NeW1E Add ❑ Alter ❑ ' Repair
❑ Demolition: ❑
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.
70(10) of Division 3 of the Business and Professions Code, and my license is in.full force and
effect. - - K- ,r t -•cF -.•,rµ ;
w
'
SIGNATURE i• DATE
+
z OWNER -BUILDER DECLARATION
• I hereby affnrtn that 1 am exempt from the Contractor's License Law for the following
Estimated Valuation'
reason: (Sec.:7,031.5,Bushess and Professions Code: Any city or county which requires a
T
• , permit to construct, after, improve, demoush, or repair any structure, prior to its issuance also
:
loContractor's's tense ilea
'• "'theuprovisioaspol w,sChhaapptera9(corn eancing with Sectiionu7o 0)
PERMIT -
AMOUNT
that of
Divislon' 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).
0 I,
Plan Chk. Bal.
,:.
4904 a 40 r
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
,
Const.
a', t
'
_ Code: The Contractors 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 drrprovements are not intended or offered for sale. 1r', however, the building`s
or improvement is said within one year of completion, the owner -budder will have the burdenm
EIBCtfICal ••
'
of proving that he did not build or improve for the purpose of sale.)
_
O I, as owner of the property, am exclusively contracting with licensed contractors to corF
-Bus-mess
Plumbing
"
struct the project. (Sec. 7044, and Professions Code: The Contractor's License Law
does not apply to an owner of property who builds or improves thereon, and who contracts for6.
S.M.I.
23
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
Grading
Driveway Enc.
Date owner
Infrastructure
• 98
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 -
b 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 ($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' Ow
REMARKS ikvtiY. tlrElms- Y15(4 it9R s',ii +7GFF 4 t
ner
NOTICE TO APPLICANT: 11, after, making this Certificate of Exemption you should become
ZONE:
BY: '>
subject to the Workers' Compensation provisions of the Labor Code, you must forthwith-
:Comply With Such provisions orthspemr8Shall bedeemed 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 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.
6-15-89.
I certity 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-. L
mentioned property for inspection purposes ..
Validated by:
Signature of applicant Date
-
Mailing Address
V811datlOn:
„ ..
City, State, Zip
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
1ST FL SQ. FT. ® $
UNITS
SLAB GRADE 7 C
6 aw
ROUGH PLUMB. BONDING
YARD SPKLR SYSTEM
2ND FL SQ. FT.
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
MOBILEHOME SVC.
BAR SINK
POR. SQ. FT. ®
G
A?
GAS (ROUGH) (' &?,, ETER LOOP
GAR. SO. FT. ®
POWER OUTLET
ROOF DRAINS
GAS (FINAL) Z- /TEMP. POLE
DRAINAGE PIPING
CAR P. SQ. FT.
GROUT
WALL SQ. FT.
FINAL INSP.
DRINKING FOUNTAIN.
SQ FT ®
URINAL
ESTIMATED CONSTRUCTION VALUATION $
_$
WATER PIPING
NOTE Not to be used as property tax valuation
FRAMING
FLOOR DRAIN
MECHANICAL FEES
WATER SOFTENER
VENT SYSTEM FAN EVAP.COOL HOOD
SIGN
WASHER(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.
SQ. FT. ® c
BATH TUB
SQ. FT. ® c
WATER HEATER
MAX. HEATER OUTPUT, B.T.U.
SO. FT. RESID ® 1% c
SEWAGE DISPOSAL
INSULATION/SOUND
SQ.FT.GAR ® Vic
HOUSE SEWER
FINISH GRADING
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
dL,r=rte 4!56-c;0
SETBACK
ROUND PLUMBING UNDERGROUND
A.C. UNIT
COLL. AREA
SLAB GRADE 7 C
6 aw
ROUGH PLUMB. BONDING
HEATING (ROUGH)
STORAGE TANK
FORMS
SEWER OR SEPTIC TANK ROUGH WIRING.
DUCT WORK
ROCK STORAGE
FOUND. REINF. z
G
A?
GAS (ROUGH) (' &?,, ETER LOOP
HEATING (FINAL)
OTHER APPJEOUIP.
REINF. STEEL
GAS (FINAL) Z- /TEMP. POLE
GROUT
WATER HEATER SERVICE
FINAL INSP.
BOND BEAM
WATER SYSTEM
GRADING
cu. yd.
$ plus x$
_$
LUMBER GR.
FINAL INSP.
FRAMING
FINAL INSP. elm
ROOFING
4r
r
REMARKS:
VENTILATION
FIRE ZONE ROOFING
FIREPLACE
SPARK ARRESTOR
GAR FIREWALL
LATHING 0
MESH
INSULATION/SOUND
FINISH GRADING
FINAL INSPECTION
CERT. OCC.
FENCE FINAL
INSPECTOR'S SIGNATURESIINITIALS
'
GARDEN WALL FINAL
1
Jun 20,88 16:48 GIBRALTAR LOANS E RANCHO MIRAGE E FAX# 619-321-5672 p.01
Oats: /D- 3/-a,9. .z
To"whom it may concern:
We are currently in the p ocess of purchasing a living unit
located at =6166"PL, Calif: in
the project.
We have chosen to allow the closing of escrow on this unit prior
to the installation of carpeting in the unit.
••G�i9c�iY�.s �•�vc�c-�_•t�.
We hereby certify that we hold the seller,
ASSOCIATES, totally and f ully'non-responsible for any potential
deleterious consequences that may occur as a result of this
decision.
Blayer date �-5:21uyer date
Buyer date
lCa