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04581 (AR)4d P.O. BOX 1504 Building51-„,503 Berm as LA QUINTAC Address CALIFORNIA 92253 CIA. .581 Owner Sohn flitchiner y BUILDING: TYPE CONST. A.P. Number OCC. GRP. 773-145-014 Mailing Address P, 0- Box 438 ” City Zip Tel. La QuiAtia 92253 Legal Description Project Description ry AddAtion — Phann IT Contractor Address 3i »b � • City Zip Tel. State Lic. City & Classif. Lic. # Sq. Ft. 140 Size No. No. Dw. Stories Units Arch., Engr., Designer New ❑ 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 full force and effect. %l:a� SIGNATURE- "-' DATE `. a ;-c. OWNER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following 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, 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). 0 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 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.) Estimated Valuation r" PERMIT ' AMOUNT Plan Chk. Dep. Plan Chk. Bal. • Const. bZ • 5U Mech. lu • UU Electrical.<i3 Plumbing 0 1, 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 S. M. 1. .50 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) O 1 am exempt under Sec. B. 8 P.C. for this reason 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 ❑ Copy is filed with the city. O Certified copy is hereby furnished. TOTAL REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100). valuation or less.) 1 certify that in the performance of thg work for which this permit is issued, 1 shall not- `- �y }�y 1 4i i`3"'`L'i� tt �1 •f, [sly 411 6-UtA,)7 1:j, 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 Side Street Setback from Center Line 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.) Side Setback from Property Line Lender's Name FINAL DATE Issued by: Validated by: IN ECTO R SPECTO N 114/88 Date Permit 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. 1 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 Date Mailing Address Validation: GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILE City, State, Zip - - - WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING; CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO F1 rp 3 UNITS LAB GRADE� OUGH PLUMB/6,)7-CIC-- BONDING SPKLR SYSTEM 2ND FL SO FT. aYARD FORMS / -�� w r. SEWER OR SEPTIG TANK BOUGH WIRING/,j MOBILEHOME SVC. BAR SINK POR SO FT0 GAS (ROUGH) METER LOOP GAR SO. FT. a POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. SO FT. a GROUT WATER HEATER WALL SO. FT. a FINAL INSP. DRINKING FOUNTAIN BOND BEAM WATER SYSTEM URINAL SO. FT. ra -$ LUMBER GR. ESTIMATED CONSTRUCTION VALUATION S FINAL INSP. f� •SG WATER PIPING NOTE, Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTONDISH I APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING LAUNDRYTRAY AIR HANDLING UNIT CFM FIREPLACE 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 g I'A c SEWAGE DISPOSAL SO.FT.GAR g 3Vc HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL T07AL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB FEE STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK -I-. ,ROUND PLUM BI ��jsj UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE� OUGH PLUMB/6,)7-CIC-- BONDING HEATING (ROUGH) STORAGE TANK FORMS / -�� w r. SEWER OR SEPTIG TANK BOUGH WIRING/,j DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIF. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING a cu. yd. $ plus x$ -$ LUMBER GR. FINAL INSP. f� •SG FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREWALL4z a c� LATHING MESH IN ULATIONISOUND /L FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS , GARDEN WALL FINAL Building Address l Owner e Address SOK' (/,�;oO— T,&t 4 4 Q" City a Zip Tel. Contractor ress State Lic. City & Classif. I Lic. # Arch., Engr., Designer ` 1_�, 'R , &)N p P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Address Tel. Pa. Bzx Q575 1564 - 3 iP�r IZip19�3 I�i�t# ci-30a6 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. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, 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 the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) 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 (8500). ❑ 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 or 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 orImprovement is sold within one year or 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 improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 aim, exempt under Sec.---,—,- ec. B. & P.C. for this reason Date (_ - 6&fOwner 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 (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. CONSTRUCTION LENDING AGENCY I=firm 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 it 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 appl .Mailing Address_ City, State, Zip - FINANCE APPLICATION ONLY UILDING: TYPE CONST. ,t OCC. GRP. T .P. Number 77.3 — I S — 6/ l/ egal Description 5l 5b3. AVE. 6, IMUCA-) PCNA- roject Description AMITIeP Sq. Ft. 1( Size New ❑ No. Stories No. Dw. Units Alter Repair ❑ 'Demolition ❑ SO4 ' 9,,l= Anre, /s F&e00*/T /3,6 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS AMOUNT 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: Validation: