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10923 (ELEC)-7 -7 75 -YO T4,ht " North side o rroba between P.O. BOX 1504 Buildingfibre OD grid C8rt8a�8 7&105 CALLE ESTADO Address $ LA QUINTA, CALIFORNIA 92253 Owner PALMER CABLE BUILDING: TYPE CONST._ No. 1©923 OCC: GRP. _ Address 41725 COOL A.P. Number City Zip Tel. PALM DESERT 1 922513 1340-1312 Legal Description Project Description ELEC. PEDESTAL Contractor TAECLZENS SERVICE Address 77811 SINALOA City Zip Tel.: LA QUINTA 192253 568-4800 State Lic. . City & Classif. C10-502256 Lic. # 1567 Sq. Ft. No. No. Dw. Size - Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of•the Businessand Professions Code, and my license is in full force and effect ! < %V/11 �GNATURE Y. Y. i` f —f —/DATE OWNEWBUILDER DECLARATION I hereby affirm that I am exempt from the Contractors 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 tie 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 Cade, 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 doll= ($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 Estimated Valuation - $350 PERMIT AMOUNT Plan Chk. Dep. - Plan Chk. Bal. OOrISt. Mech. 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. It, 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 safe.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con• Electrical Plumbing $ 30 struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who fields or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) 0 1 am exempt under Sec- R- & P.C. for this reason S.M.I. Grading 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.) ' Polic�No. Companyrv[�sr pCopy is filed with the city. O Certified copy is hereby furnished. ' ! if.� '+1�� c;� �1�''C�.7. i 5•' r„ , m• -� m Js TOTAL $30 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS (This section need not be completed it the pend is for one hundred dollars ($100) valuation or less.) I certify that in the performance of ttme 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: fl, 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 pend shag be deemed revoked. ZONE: BY: 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 Lenders Name Lender's Address This is a building permit when property filled out, signed and validated, and is subject to expiration it 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 orf this city to enter the above-. mentioned property for inspection purposes FINAL DATE Issued by: Validated by: INSPECTOR Date Permit 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 2ND FL SQ. FT. BONDING YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® GAS (ROUGH) DRAINAGE PIPING WALL SQ. FT. OTHER APPJEQUIP. DRINKING FOUNTAIN. SQ FT ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. a� 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 I WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL GAR. FIREWALL SQ.FT.GAR ® 34C HOUSE SEWER LATHING 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 WIRINI$;�?1&2tb 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. a� FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION - AV CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL