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002389 (RPL)Building 52-555 Address Owner Mailing Address City Zip Tel. 92253 Contractor ILS . _ Address P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPECONST. OCC: GRP. A.P. Number Legal Description Project Description City... _ d... Zip.. PaIx±2 3 92262 Tel.. 1-324.6996 State Lic. & Classif.21 City j Lic. # CaY% Sq. Ft: No. No. Dw. Size Stories Units Arch.; Engr:,. Designer New ❑,� Add ❑ Alter ❑ . - Repair ❑ Demolition O Address Tel. City Zip State .... _. Lic. #30 x 3 ' ..a.-. _ LICENSED CONTRACTOR'S DECLARATION , ' hereby affirm that I am licensed under provisions of,Chapter 9 (60mmencing'with Section r 7.000) of Division of the Business and Professions Code, and my license is in full force and / effect. 3 v^�y Y/ �� f f/ jr-•� 1� .. . `SIGNATURE C4 "- _ ` •(t -_ `. b' r " DATE " dWNER•BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the followingGam"����� 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 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, orthat. 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 (8500). ' �. O I, as owner of the property, or my employees with wages as their sole compensation, will' . -do the work, and -the structure isnot 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 Estimated Valuation . ' PERMIT - AMOUNT - - . Plan Chk.Dep.. - C 9 --Plan Chk. Bal. V •, @� Const.' 'I?V •JV Mech. ' . 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.) . - , Electrical - -��� 9 - Plumbing 52.00 ❑ 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 contractor(s) licensed pursuant to the Contractors -License Law.) ❑ I am exempt under Sec. B. & P.C. for this reason. .. S.M.I. s.74 ' Grading 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 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL .ryvu2.7y •R 46 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE REMARKS - - - (This section need not be completed if the permit is for one hundred dollars (8100) 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: 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. ZONE: --BY: Minimum Setback Distances: - - - Front Setback.from Center.Line Rear Setback from Rear Prop. Line . CONSTRUCTION LENDING AGENCY - Ihereby affirm that there is a construction lending'agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) _ - Side Street Setback from Center Line ' Side Setback from Property Line. Lender's Name FINAL DATE _ _ INSPECTOR—' _ Issued by- Date 2C2 Permit - Validated by: Validation: A 5 6 8 9 5 29 18346 CR Lender's Address . This is a building permit'when properly filled out, signed and validated, and is. subject to expiration it work thereunder is suspended for 180 days. .�y� I certify that I have read this application and state that the above information is correct. 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 applicanit 1-i.:+"a >`t''r xx.. -: Date MailingAddress f '✓ v f j City, State, Zip ``r ' HARD COPY r.- CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. ' SQ. FT. p POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ. 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 GRADEOUGH FLOOR DRAIN MECHANICAL FEES 12 WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER SEWER OR SEPTIC TANK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK 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. SQ. FT. ® c BATH TUB SQ. 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 GRADING cu. yd. $ -plus-x$_=$ 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 A.C. UNIT COLL. AREA SLAB GRADEOUGH PLUMB. 12 //__UNDERGROUND �sONDING 1, / HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK OUGH WIRING6 v DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. 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 MESH INSULATION/SOUND FINISH GRADING / ifAL INSPECTION !� CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINAL POOL AREA TO BE 'E_*-;9C!L0r.A7c- BY MINIMUM 5 1='�. HiGH FE-NoE. ALL GATES TO BE SELF-CLOSING AND SELF -LATCHING. Commun'ty — De -ve—' - lopment/Bldg. -Dept. CONNHONALl Y . ACCEPTED 'FOR COW�TRUCTJON_ SUBJECf TO ONSTALLAT16N AS PER AND ALL APPI------------------- WA"C15D-ES ®ATT: