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11408 (RC)Buildil rig Address ` Highway 111 Owner ' €dash ngton AdaMS Partnership Mailing Address City lZip ITel. P.O. BOX 1504 ' ` ` y 0 . 1 J "C 01,J 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 \ +� lv BUILDING: TYPE CONST. OCC: GRP. A.P. Number + Legal Description Contractor t)es.-,? t :it -Le rievelopnient Project Description Tenant Ixrapr6vement Shop E2 Address _ �9 39725 Garard City Zip Tel.: requires the applicant for such permit to file a signed statement that he is licensed pursuant to PERMIT - AMOUNT 92260 345--2472 ' Division 3 of the Business and Professions Code, or. that. he Is exempt therefrom, and the basis for the Any Section 7031.5 by 'any State Lic. City & Classif. 620242 Lic. # 2103 Sq. Ft. No. No. Dw. Size Stories Units Arch:, Engr., New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Designer Address Tel. Mech. . ,. 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 City lZip , Stade„_. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- / LICENSED CONTRACTOR'S DECLARATION I hereby affirm thatil am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3�//o�f the Bus'ness and Pr/ofessions Codett; and myAA(cense is in full force and effect. / f ,! / _ / a � r'/ s'- 47i 1 a" f /OWNER -BUILDER DECLARATION L �' Estimated ValuationQ�. I hereby affirm that I am exempt from the Contractor's License Law for the following �9 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 PERMIT - 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 Any Section 7031.5 by 'any Plan Chk..Dep.. alleged exemption. violation of applicant -for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). - Plan Chk. Bal. 29.25 ❑ 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. 45.00 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, Mech. . ,. 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 Electrical 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 21 .. 00111x2ft 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 S.M.I. •- such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) • Grading 0.1 am exempt under Sec. B. & 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, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy0o. Company ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL. J5 CERTIFICATE OF EXEMPTION FROM REMARKS ._WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (S100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any erson in any manner so as to become subject to the Workers' Compensation Laws of Cali ornia. +t ;J_� r 1� yw,` t Veit t�E�1t�'tf i"" tt e Date Owner --Aq NOTICE TO APPLICANT. If 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 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 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. 1 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 FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SQ. FT. ® CARP. SQ. FT. WALL SQ. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. 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 ® 3/ic HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEESMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING R 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 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 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