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15798 (SIGN)Building 78822 WINY Ill Address Owner Carr. Reynolds � P.O. BOX 1504 78-495 CALLE TAMPICO LA OUINTA, CALIFORNIA 92253 Mailing Address 461001 Washington St City Zip Tel. La Qurota 92253 283-2191 Contractor California Veon P.oduets Address 4530 Mission Gorge P1. City Zip Tel.: San Diego 92120 283-2191 State. Lic. • 176699 City '& Classif. r Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # r,ysLICENSED CONTRACTOR'S DECLARATION -_/I herebylaffirmfthat 1/am licensed under grovSsions of Gthapter 9 (commencing with Section 7000) of Division 3 of the Business and P fessioris C e, and my license is in full force and effect. • - .,✓ ! 7 - fi • ��GNATURE DATE OWNER -BUILDER' DECLARATION I hereby affirm that I 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 permit to construct, after, improve, demolish, 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 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 alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a cWl penalty of not more than rive hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as.their sole compensation, will do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Buisness and Professions -Code:. The Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such Improvements are not intended or offered for sale. If, however, the .building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or Improve for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and .Professions Code: The Contractor's License Law does not apply to an, owner of propertywhobuilds or improves thereon, and who contracts for such projects with contractors) licensed pursuant to the Contractor's License Law.) O lam, exempt under Sec. B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker'syCompensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy Flo. Company © Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($.100) . valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject'to.the Workers' Compensation Laws of California Date Owner NOTICE TO APPLICANT: It, 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 permit shalt be deemed revoked. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND 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, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ` This -As 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 1 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 of this city . to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 15798 Ti BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description��� Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑" Alter ❑ Repair ❑ Demolition ❑ r Estimated Valuation 15 Q v chi . (D33 PERMIT AMOUNT Plan Chk. Dep. Distances: Plan Chk. Bal. Front Setback from Line Const.,1� u HiQ Mech. Side Street Sett om Ce Line Electrical Side Setbaclyf m Pr erty Plumbing �� S.M.I. IN1S Grading Driveway Enc. Date �Pit Infrastructure \'� �s / Validated by: , TOTAL $162.00 HtMAHK5 ZONE: BY: Minimum Setback Distances: Front Setback from Line Rear Setback from ro Line Side Street Sett om Ce Line Side Setbaclyf m Pr erty �� FINAL DATE IN1S Issued by: Date �Pit \'� �s / Validated by: , CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES 1ST FL. ' SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SO. FT. ®' BONDING YARD SPKLR SYSTEM POR SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT, ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. GAS (ROUGH) DRAINAGE PIPING WALL SO. FT. OTHER APPJEOUIP. DRINKING FOUNTAIN. SO. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation - FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER NSP •� G I—NA L INSP///-4n 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. SO. FT. ®c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/a c SEWAGE DISPOSAL GAR. FIREWALL SO.FT.GAR ® 3/ac 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 I 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 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. NSP •� G I—NA L INSP///-4n 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