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06018 (RPL)4 P.O. BOX 1504 No. 06018 Building 53-760QUINOTACL CALIFORNIA 92253 Address s3-7�AVE. Ramirez LA Owner Western Acmrican Builders Mailing BUILDING: TYPE CONST. OCC: GRP.• Address 52-425 Ave. BerwdasA.P. Number 774-162-000 City Zip Tel. La Quints 1 92253 564-7411 Legal Description dater Trends f♦aaress 1390 t. E. 5th St. 0101 Zip Tela Beaumont 92223 778-:121 State Lic. I City 8 Classif Cr5-3560471 Lic. # Arch., Engr., Designer Address Tel. City IZip I State I 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 Cade, and my license is in full force and effect. r„!-`}-4 SIGNATURE n DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,Buso7ess and PhAessions Code: Any city or county which requires. a Permit to construct, after. improve, demolish, or repair any structure, prior to its issuance also ires the for such t that he is licensed the provisionapplicant Contractor's License Law, �t r 9(c( recommencing with Sectiopursuant 0 0) of Division 3 of the Business and PMtessibm Code, or that. he fs 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 cid pefWly of of more than fire 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 Contractors 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 of 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.) ❑ 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 irproves thereon, and who contracts for such projects with a contractor(s) Goensedpursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec_ R_ & P.C. for this reason Date Owner 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 fumished. CERTIFICATE OF EXEMPTION FROM D WORKE' COMPENSATION INSURANCE (this section need not be completed it the permit is for one hundred dollars (S100) valuation or less.) I certify that in the performance of ffng work for which this permit is issued, I shall not =any pperson in any manner so as to becbme'subject to the Workers' Compensation Laws of Callfomia ; Date 1-01-41 j % net NOTICE' TO' APPLICANT: ff. after makfig 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 pem* 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 Lenders Address This is a building permit when property 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 to building construction, and hereby authorize representatives mf this city to enter the above-. mentioned property for inspection purposes Signature of applicant Date Mailing Address City, State, Zip Description Dual and Spa Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ - TOTAL REMARKS xt c t rn a 4A "..-.A : LWIn, t 1111 # f :Y: 1:.: 1, :11?V } 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 6-2©-89 Issued by: Date Permit Validated by: Validation: Estimated Valuation 11,554.E PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $7.75 Const. 135.00 Mech. Electrical Plumbing 27.00 S. M.I. .84 Grading Driveway Enc. Infrastructure TOTAL REMARKS xt c t rn a 4A "..-.A : LWIn, t 1111 # f :Y: 1:.: 1, :11?V } 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 6-2©-89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEEO- 1ST FL. SO. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SQ. FT. @ BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® ROUGH WIRING. GAR. SO. FT. @ POWER OUTLET ROOF DRAINS FOUND. REINF. GAS (ROUGH) DRAINAGE PIPING CAR P. SQ. FT. ® HEATING (FINAL) WALL SO. FT. REINF. STEEL DRINKING FOUNTAIN. TEMP. POLE URINAL SO FT ® GROUT ESTIMATED CONSTRUCTION VALUATION $ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER LUMBER GR. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FRAMING LAUNDRY TRAY AIR HANDLING UNIT CFM ROOFING 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 FIREPLACE SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE fPL.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 FINAL INSP. ROOFING 7— REMARKS: VENTILATION FIRE ZONE ROOFING. FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL