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14664 (PLBG)Building Address i 51-845 Ave. Rubio Owner Rod Wright mailing Address same CityZip Iia Quinta, CA 92253 Contractor M ys'�!1:7 .D. Net�?2cal �V=eqs%fi C©Untjy Chita, 3D State Lic. & Classif. . Arch., Engr., Designer Address P.O. BOX 1504 No. 14664 78-495 CALLE TAMPICO er` LA QUINTA, CALIFORNIA 92253 BUILDING TYPE CONST..- OCC: GRP. A.P. Number Legal Description Project Description 106.1 of'natural gas line DUnea, CA 92201 --3451-3656 C-36 519599V City 1162 Lic. # Tel. Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ . - Alter ❑ Repair ❑. Demolition ❑ 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 full force and. effect. $1GNATURE - DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Susiness .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 file a signed statement thathe is licensed pursuant.to . the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 9000) 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 civil penalty of not more than five 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 withlin one year of completion, the owner -builder will have the burden proving that he did not build or knprove for the.purpose of sale.) 6p, `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) (kensed pursuant to the Contractor's License -Law.) ❑ 1 am exempt under Sec. B. t P.C. for this reason s/ f e- I s Estimated Valuation $���© . - I - PERMIT • - - - - AMOUNT Plan Chk. Dep. Plan Chk. Bal. COr1St . ' Mech. - "EleCtrlCal • - Plumbing 30.00 S.M.I. - - - Grading Driveway Enc. `Dataowner Infrastructure WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker'sCompensation Insurance, ora certified copy thereof. (Sec. 3800, Labor Code.) Pol'c o. Company 'D Copy Is filed with the city, O Certified copy is hereby furnished TOTAL 30.0l CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed. it 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, aftei making this Certificate of Exemption you should become' subject 'to the Workers' Compensation provisions of the Labor Code, you must �Iorthwith comply with such provisions or this permit shall 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. ' Ttiis 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 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 10 building construction, and hereby authorize representatives .of this city to enter the above-. mentloned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip REMARKS ZONE: BY: 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 Permit— Validated by: LX U _ r CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FEES IST FL. SO. FT. ® $ UNITS - 4 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 APPIEOUIP. DRINKING FOUNTAIN SO. FT. ® TEMP. POLE SERVICE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES _$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 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, 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 ® 11/4 c SEWAGE DISPOSAL LATHING SO.FT.GAR ® 3/ac HOUSE SEWER MESH 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. 2eI �0 "5 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 APPIEOUIP. REINF. STEEL GAS (FINAL) �� TEMP. POLE SERVICE FINAL INSP. GROUT WATER HEATER 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 SIONATURESIINITIALS GARDEN WALL FINAL