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14908 (RC)P.O. BOX 1504 No. 14908 Building 78-'822 H 111 •78-495.CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner Washington/Adams Partnership K . 132 Mailing BUILDING: TYPE CONST: OCC: GRP. Address 2377 Crenshaw Slur, , Ste. 300 A.P. Number 643--080-021 City Zip Tel. Torrance, CA, 90541 (310618-3600 Legal Description Contractor Project Description T6n ant Improvement Address _ .39725 Garant,, Ste. B City zip Tej.: Palm desert-, 1:A 92260 345-2472 State Lie. - City & Classif.. B 16320242. Lie. # 21.08 Arch., Engr., Designer. Address Tel. City Zip State Lie. # LICENSED CONTRACTOR'S DECLARATION I hereby yffirm �thatul.a�mm,,,icen$ed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busifiess and Professions Code, and mylicense is Of 11 fore and �f9� SIGNATUsaE �,� / / F DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lawfor the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires,a permit to construct,. atter. Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to Ole, a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or Division 3 or 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 subjects the applicant to a civil penalty of not more than Ove hundred dollars ($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 or property who 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. If, 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 bulld or knprove for the purpose of sale.) If O I, as owner of the property, am exclusively contracting with licensed contractors to con- 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 such projects with'a contractors) licensed pursuant to the Contractor's License Law.) r ❑ 1 am exempt under Sec B. & P.C. for this reason Date Owner 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. . CERTIFICATE OF EXEMPTION FROM . WORKERS' COMPENSATION INSURANCE (This section need not be completed N 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 Agri) I•r►rtp I AT`4-Ft Z �$$'�,� lri piat�•csa Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ rifR111/►Z T>>?T r.�'_ } Date Owner NOTICE TO APPLICANT., N, after making this Certificate or Exemption you. -Should become 'ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith ' comply with such provisions or this permit shall be deemed revoked. - Minimum Setback•DlStanceS: " Front Setback from Center ' Rear Setback from Rear in Estimated Valuation ,®i©0Q.00 Side Street Setback fr nter Lin PERMIT AMOUNT Plan Chk. Dep. Side Setback from perty Line Plan Chk. Bal. • Const. _ Mech. FINAL DATE T Electrical ' _� • Plumbing Issued by- • S.M.I. nn Grading ITV' Driveway Enc. Validated by: Infrastructure 4 Arts in Publilacen 1,910.31 City, State, Zip TOTAL to -,Ivy REMARKS I certify that in the performance of the work for which this permit is issued, I.shall not Agri) I•r►rtp I AT`4-Ft Z �$$'�,� lri piat�•csa employ any, person in any manner so as to become'subject to the -Workers' Compensation Laws Calfornia.Ffafi of 1iWisT'AY4CSC).]'Yti?i rifR111/►Z T>>?T r.�'_ } Date Owner NOTICE TO APPLICANT., N, after making this Certificate or 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•DlStanceS: " Front Setback from Center ' Rear Setback from Rear in WARNING: FAILURE TO SECURE WORKERS'COMPENSATIONCOVERAGE IS.UNLAWFUL:AND Side Street Setback fr nter Lin SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES .UP TO ONE HUNDRED.THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST.OF COMPENSATION, .. Side Setback from perty Line DAMAGES AS PROVIDED FOR. IN. SECTION 3706 OF. THE LABOR.CODEi INTEREST, AND • ATTORNEY'S FEES. This is a building permit when properly filled out, signed and validated, and is subject to, FINAL DATE T 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 I agree to comply with all city and county ordinances and state laws relating to building. nn construction, and hereby authorize representatives of this city to enter the above-: ITV' mentioned property for Inspection purposes. Validated by: Signature of applicant a Date 4 Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. BONDING YARD SPKLR SYSTEM FOR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT, ® POWER OUTLET ROOF DRAINS CARP. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. F7. OTHER APPJEOUIP. DRINKING FOUNTAIN SO. 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. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM C✓-i.� 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. SO. FT. RESID ® 1+/4 c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® Vic 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 WIRING DUCT WORK ROCK STORAGE 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 A Tl,-lc�/i!� C✓-i.� REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESIINITIALS GARDEN WALL FINAL