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002435 (RR)P.O. BOX 1504 Building 31-630 Awa Rubio78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner Mailing Address Sam City Zip Tel. La. Quitta. .92253 Contractor C.M. rMfiW, Cb. Address r .. No. 002435 WILDING:- TYPE CONST. OCC: GRP. t.P. Number .egal Description 'roject Description P.O. B= 1256 I3Y: Minimum Setback Distances: -' City .. Zip Tel.. Rear Setback from Rear Prop. Line Side Street Setback. from Center Line Side Setback from Property -Line FINAL. DATE State Lic. City Date 6" 3 Permit Validated by: & Classif. 352007 Lic. # 319 Sq. Ft. No. No. Dw. A588Z 6 30 3a00 U. Size Stories Units Arch., Engr.; Designer New q Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # 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-fullforceand effect.. SIGNATURE r.., a'rs..., .A;_$./' ..DATE ' OWNERwBUILDER DECLARATION I hereby affirm that I am exempt from the contractor's License Law for the following�� Estimated Valuation ' reason: (Sec.. 7031.5,Business and Professions Code: Any city or county which requires, a -to A permit construct, after, 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 o 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 penally'of not more than five hundred dollars ($500).' Plan Chi<. Bal. ❑ 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.'�� 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•bullder will have the burden _ Electrical ' 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- Plumbing 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 ❑ 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.) 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 if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thg 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. Dale Owner NOTICE TO APPLICANT. If, 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 shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY 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.) 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. 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 r ; ,-..,. Date f �' Mailing Address �. City, State, Zip HARD COPY TOTAL30.00 REMARKS ZONE: I3Y: Minimum Setback Distances: -' Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback. from Center Line Side Setback from Property -Line FINAL. DATE INSPECTOR -Issued by; Date 6" 3 Permit Validated by: Validation: A588Z 6 30 3a00 U. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. @ $ 2ND FL. SO. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SO. 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.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRYTRAY 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 Q 3/ac HOUSE SEWER REMARKS: VENTILATION 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 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. FRAMING FINAL INSP. ROOFINGetj( kj�3V / Jo i REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND ' FINISH GRADING 06INAL INSPECTION( CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL ::1 - 2 r: