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001946 (SFD)4 P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 54'"405 Avenida (Curama LA QUINTA, CALIFORNIA 92253 Owner Mailing Address City Contractor C Jokinsm P.O. B= t" ,�2o Zip Tel. Zip ITel. No. 001946 BUILDING: TYPE CONST. OCC. GRP.`" A.P. Number 774-242-019 Legal Description Ftx Project Description �Siul� State Lic. City VWG 359Z or less.) & Classif. Lic. # Sq. Ft. Q�p '43() No. No. Dw. Size Stories - Units Arch., Engc; • ' NOTICE TO APPLICANT: If, alter making thisCertificateor Exemption you should become Designer New ©: Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 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 City Zip State Side Setback from Property Line, Lic. # Lender's Address LICENSED CONTRACTOR'S DECLARATION y _, INSPECTOR This is a building permit when properly filled out, signed and validated, and is subject to I hereby affirm that I am licensed under provisions.of Chapter 9 (commencing with Section 7000) of Divis�io�n.3 of the Business and Professions Code, and my license is in full force and expiration if work thereunder is suspended for 180 days."' I certify that I have K>;:�. " S7 effecty J �' i i Y—"w /" ,l.� i.. i i;� hoz Issued by: Date Permit I agree to comply with all city and county ordinances and state laws relating to building SIGNATURE - DATE _ construction, and hereby authorize representatives of./this ,city to enter the above- i f OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation .�,����� Validated by: reason: (Sec. 7031.5,Business and ,Professions Code: Any city or county. which .requires 'a Mailing Address permit to construct, alter, improve, demolish, or repair any structure, prior.to its issuance also City, State, Zip requires the applicant for such permit to file a signed statement that he -is licensed pursuant to PERMIT •e AMOUNT AMOUNT the provisions or the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 301 the Business and Professions Code, or that. he is exempt therefrom, and the basis for the Any Section 7031.5 by for PIan.Chk. Dep. alleged exemption. violation of any applicant. a, permit subjects the applicant to a civil penalty of'not more than five hundred dollars ($500). Plan Cilk. Bal ❑ 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 Const. �] «y�y ty a i J V�i Professions 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. provided that such .improvements are not intended or offered for sale. If, however, the building ,7a1V or improvement is sold within one year of completion, the owner -builder will have the burden Electrical 70,12 of proving that he did not build or improve for the purpose of sate.) _ . 0 I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing fsr� struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does to builds improves. thereon, for S.M.I.• not apply an owner of property who or and who contracts such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - Grading s. . O I am exempt under Sec. B. & P.C. for this reason Driveway Enc. 20.00 Date Owner Infrastructure �t,xax •ia 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. TOTAL�;�5. v CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'COMPENSATIONINSURANCE (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, alter making thisCertificateor Exemption you should become ZONE: BY: ' subject to the 'Workers' Compensation provisions or the Labor Code, you must forthwith comply 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 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 K>;:�. " S7 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- i mentioned property for inspection purposes. ,��•+' / Validated by: / Signature of applicantN,d�'�� P' �K - .s { `�fC'V eT Date — /i •,f Mailing Address Validation: City, State, Zip A35.20 12 10 213aG6 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. itFORMS G "1� SEWER OR SEPTINTA4 Y ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SQ. FT. ® GROUT WATER HEATER WALL SO. FT. ® FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ =$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(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, TEM/PERM 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. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER FINISH GRADING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL I TOTAL FEES MICRO FEE MECH.FEE dPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK ROUND PLUMBING y/%jUNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK itFORMS G "1� SEWER OR SEPTINTA4 Y ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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. 1-14 FRAMING FINAL INSP. f ROOFING �/ ^ VENTILATION REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREW 7 tv Of I LATHING MESH INSULATION/SOUNDOC 1 O( 5 FINISH GRADING i'•�} FINAL INSPECTION ?j 6 CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS. GARDEN WALL FINAL