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14968 (RC)r[ t " • , 414 Q P.O. BOX 1504 Buildl' ' ?8,, g Q • � 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner Hanevs Smartswear Mailing Address -same City Zip T I. L Quinta, C> 92253 354 Contractor Owner I �Uii:Cs'er Address . 4 No. 14968 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description - Project Description Tenant Improvement 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 completk Ahe permif is forone- hundred dollars (S 100) valuation, or less.) / I certify that in the perform ncerofthe work for which this•pent is issued, I shall -not, employ any person in any-mannerxso as to become subject,to'the;Workers' Compensation Laws:of^California - ti " •�-• , Dated,.0 ,�i}LL'.as,.•Q ' Driveway Enc. Infrastructure TOTAL REMARKS caner tf SVO,TICE. TO"APPLICANT: if, after making this CerflIlcate of 'Exemp an -you should become subject to 16e Workers /Compensation provisions of the Labor Code, forthwith ZONE: - City Zip Tel.: Minimum Setback Distances: - State Lic. City & Classif:.' Lic. # Sq. Ft. No. No. Dw. Arch.,- Engr., -Size Stories Units Designer New,❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. ' ' HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, r ' City Zip State ; Lic: # " This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section _ 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATURE DATE Issued by: OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractors License law for the following $1000.00 reason: (Sec. 7031.5,Business .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 Ills a signed statement that he is licensed pursuant to . PERMITAMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of mentioned property for inspection purposes.Validated Divislon 3 of the Business and Professions Code, or that. he is exempt. therefrom, and the basis for the alleged exemption. Any Section 7031.5 by 'any for Plan Chk. Dep. violation.of applicant a permit subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). rl Plan Chk. Bal. property, as owner of the roe _ do the work, and the a is not intended orofferedfor sale�r(Sec. 7044eBusn�ess and Const. ' +0 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.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project. (Sec. 7044, Susiness'-and Code:, The Contractor's License Law - does not apply to an owner of propertyrwho b6ilds or Improves thereon, and who contracts for S.M.I.. ' such projects with a.contractor(s) licensed pursuant to the Contractor's License Law.) . v %J 1101#0 Grading ❑ I am a_xempt,under Sec - B. & P.C. for this reason 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 completk Ahe permif is forone- hundred dollars (S 100) valuation, or less.) / I certify that in the perform ncerofthe work for which this•pent is issued, I shall -not, employ any person in any-mannerxso as to become subject,to'the;Workers' Compensation Laws:of^California - ti " •�-• , Dated,.0 ,�i}LL'.as,.•Q ' Driveway Enc. Infrastructure TOTAL REMARKS caner tf SVO,TICE. TO"APPLICANT: if, after making this CerflIlcate of 'Exemp an -you should become subject to 16e Workers /Compensation provisions of the Labor Code, forthwith ZONE: - BY: ' ' you must 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 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND Side Street Setback from Center Line 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 Property Line DAMAGES AS PROVIDED FOR IN SECTION 3706 OF .THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. " This is a building permit when property filled out, signed and validated, and is subject to FINAL DATE INSPECTOR 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.. I agree to comply with all city and county ordinances and state. laws relating to building Issued by: Date ---Per • construction, and hereby authorize representatives -of, this. city to enter the above-. Q mentioned property for inspection purposes.Validated by: j Signature of applicant Date !' Halling Address Validation: I City, State, Zip . v %J 1101#0 VW 7 . r CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINU FlES' 1ST FL. SO. FT. ® $ 2ND FL. S0. FT. POR. gQ, FT, ® GAR. SQ, FT, ® CARP. SO. 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 WATER HEATER SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL BOND BEAM SO.FT.GAR ® 3/4c HOUSE SEWER $ 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 1 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 ` (G REMARKS: VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION 3 CERT. OCC. 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