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RPL (11056)914 _ P.O. BOX 1504N o . 11.0 5 6 Building 80_j95. ''�eil©� 78-105 CALLE ESTADO Address LA QUINTA; CALIFORNIA 92253 Owner Tech sNovascone Mailing BUILDING:- TYPE CONST. OCC: GRP. Address 5c"1me.. as above. A.P. Number. City Zip Tel. fat Quiz�ta 92253 . 7.1-0112 Legal Description Contractor Project Description' Geclx'gP Ifartinov.cYi,' jr.A. Address . Pool - and Spa 950 Ax�e •. City Zip. Tel.: Ther tnGl 92274 399-5655 State Lic. City & Classif.El�3672 Lic. # Sq. Ft. No. , No. Dw. Arch.,,Engr:, r Size :. _. _ `' Stories Units e Designer New ❑•" Add ❑ Alter Repair ❑ . -Demolition-0. Address I Tel. . City Zip State ... ; Lic. # LICENSED CONTRACTOR'S DECLARATION ' I hereby aff irmbthat I am licensed•u d r provisions of Chapter 9 (commencing with Section ff.c . Division 3 of the Busyness and.Prciessfons Code, and my license is in full force and - effete :/a 1GNATURE' ✓\ "" DATE OWNER -BUILDER DECLARATION Estimated Valuation 1 hereby affirm that 1 am exempt from the Contractor's License Law for the following, reason: (Sec. 7031.5,Bustness- and Professions Code: 'Any city or; county which requires - a >. V permit to construct, alter, improve, demo/ , or *repair any structure, prior to its issuance also requires the, applicant for such permit to rile a signed statement that, he is licensed. pursuant, to •- .• PERM IT, - 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 thealleged 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 rive hundred dollars.(S500). ❑ I, as the wmll '~ .t: -lan- a Bal: ' B _ 76.Bs owner of roe p p property, or my wages as their sole compensation; do the work; and the structure is not intended -or. offered for sale. (Sec.. 7044, Buisness and - Professions Code:. Contractor's License .Chk. Const.117.00 . Law does notapplyto 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 nor .intended- or. offered, lor..sale. If, however, the building Mech. , �. ' -. •,� . �•A-0.- 2 4 ., or Improvement is sold.within one year ol;cornpletion,•�the owner -builder will have the burden Electrical ' ` '• ' . of proving that he did not _build or Improve for the purpose of.sale y. , . . , 5 e O ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con-, , • Plumbing. 27.00 0O • 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 bnproves. thereon, and who contracts for - such projects with a contractor(s) licensed pursuant to the,Contractor's License Law.) • _ - Grading '0.1 am exempt under-Sec.—B. 8 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, ora certified.copy thereof..(Sec. 3800, Labor Code.) _ r Policy No. .Company ' 151 Copy is filed with the city.. ' ❑ Certified.copy is hereby furnished: TOTAL 2• (3' ii 5 - CERTIFICATE OF EXEMPTION FROM REMARKS;.' a WORKERS' COMPENSATION INSURANCE :. (This section need not be completed H the permit is for one hundred dollars (S 100) valuation - •,-. . ' or less.), - .. _ . I certify .that in the performance of the work for which this permit is issued, I shall not =7 '•'�•a7�'r+rj�1 employ 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 - ZONE:— subject to the Workers' Compensation' provisiais of the. Labor Code, .you must•forthvkh: comply with such provisions or this permit shaft be deemed revoked... Minimum Setback DlStanCE!9: Front Setback from Center Line r _ Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side,Street Setback from Center -Line 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.) Side Setback from Property Line Lender's Name Lenders Address ' This is a building permit when property filled out, signed and validated, and is subject -to FINAL DATE INSPECTOR 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. Issued by: Date Permit - 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. Val Idated 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. SQ. FT. POR. SO. FT. ® GAR. SQ. 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. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 C SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER REMARKS: 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 INSULATION/SOUND INISH GRADING NAL INSPECTI012SJ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL