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002726 (BLCK)Twit autra -4 Address 52-940 Averlida lfts�� Owner . Mailing Address P.O. Box 580 CityZip Tel. ..2Q Contractor Aaoress. City.. Sam Zip Tel..... State -Li c. City & Classif.. Lic. # . Arch.; Engr., ' Designer P.O. BOX 1504 UU 41 Z 0 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST: OCC: GRP. A.P. Number Legal Description Project Description Sq. Ft. m� 't.. ri N0. Size Stories LNew Add ❑ Alter ❑ -No. Dw. Units Repair ❑ Demolition 0 Address Tel. r6 � n. feet of 4-. high '41 fr CityZip State Lia # _ :.. _LICENSED CONTRACTOR'S DECLARATION • hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section. u 7000).of Division 3 of the Business and Professions Code; and my license is in full force and - effect. . • _SIGNATURE DATE .. ... - .... .. ... ... OWNER -BUILDER DECLARATION .. Estimated Valuation A hereby affirm that I am exempt from the Contractor's License Law for the following 7031.5,Business Any /��q �s aa�� - $. �'..09n.so reason: (Sec. and Professions Code: .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 -PERMIT - • AMOUNT the provisions of the Contractor's License Law, Chapter 9' (commencing with Section. 7000) of. Division 3 of the Business'and Professions Code, or'thaL:he is. -exempt: therefrom, and the basis for the Any Section 7031.5 by *any for Chk. Dep. alleged exemption. violation of applicant a. permit subjects the applicant to -a -civil penalty of not more than five hundred dollars ($500).' ­ . ..- .-Plan ,- Plan CFik. 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. �; Yi . _ 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 1, as owner of the property, am exclusively contracting with licensed contractors to con-- Plumbing struct the- project. (Sec. -7044, Business and- Professions. Coder 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 ❑ I am exempt under.Sec. B. 8 P.C. for this reason % t �- Driveway Enc. Date �'��'"-'owner ii / _ti•r� .- a.' ��� -a _.F Infrastructure WORKERS' COMPENSATION DECLARATION, hereby affirm that I have a certificate of consent to self•insurb, 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., 0 Certified copy is hereby furnished. ' TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE . (This section need not be completed if the permit is for one hundred 'dollars ($100) valuation or less.) `• - - - - certify that in the performance of lhg work for which this'permit is issued; I shall not tr employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date_L_' Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become ZONE: BY: subject' to the Workers" Compensation provisions 'o! the Labor Code, you must forthwith. 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 CONSTRUCTION LENDING AGENCY.. Side Street Setback from Center. Line' hereby affirm that there is a construction lendingagency for the performance of the 'work for which this -permit is issued. (Sec: 3097, Civil code.) _ - Side Setback from Property Line Lender's Name Lender's Address FINAL,DATE INSPECTOR 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. +1 Issued by: Date' 1% -20EPermit. agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives frof this -city to enter the above-. mentioned property for inspection purposes. r Validated by: // _ Signature of applicant r ;.r f r ( •Dae Mailing Address t "" Validation: City,.State, Zip A 6 7 9 8 11 20 31.85 Ck " HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL. SQ. FT. ® ROUGH PLUMB. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK ` GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. ® DUCT WORK DRAINAGE PIPING WALL SQ. FT. ® GAS (ROUGH) DRINKING FOUNTAIN SQ. FT. ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ GAS (FINAL) TEMP. POLE WATER PIPING NOTE: Not to be used as property tax valuation WATER HEATER SERVICE FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRYTRAY AIR HANDLING UNIT CFM C - 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 ® 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 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 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 1f q / !Ji FINAL INSP. ROOFING C - • 1a7S' 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 rq o _.