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003477 (BLCK)Building Addresss'— Mailing New O Add ❑ _. Address Same City • Zip Side Street Setback from Center Line Contractor Side Setback from Property Line City Zip Address . Issued by: - Date 11/ d%87Permit 72-372 Vii City Zip 1D xt n �+iM e'T f;.� «_��e-gra► i State LIO. y & Classif. 3$3.851 T4'yl - P.O. BOX 1504 No. 003477 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City Lic. # BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-135-016. 2448Legal Description Project Description 6 It X 106-' TMOCk t AIA 8-2272 Sq. Ft. No. No. Dw. Size Stories Units. I Arch., Engr., Designer New O Add ❑ Alter ❑ Repair ❑ Demolition ❑ i Address Tel. Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line City Zip State Issued by: - Date 11/ d%87Permit Lic. # LICENSED CONTRACTOR'S DECLARATION w 1 hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section I 7000) of Division 3 of the Business and Professions Code, and my license is in force and A- full ' effect!. SIGNATURE DATE i OWNER -BUILDER DECLARATION Estimated Valuation 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 file 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 Piofessions Code, or that. he is exempt therefrom, and the basis Section 7031.5 'any for Plan Chk. Dep. for the alleged exemption. Any violation of by applicant a permit j subjects the applicant to a civil penalty of not more than five hundred dollars ($500). Plan Chk. Bal. Sri? A 7 i ❑ 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. �{} �*n 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 or completion, the owner -builder will have the burden Electrical . 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- . Plumbing 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. r. A such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ I am exempt under Sec. - B. & P.C. for this reason 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. ❑ 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. r 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 Lender's Address 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. 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 City, State, Zip HARD COPY TOTAL REMARKS L1'}C 01- LA Oil fIIII tffrNj� Y(}iJ 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 11/ d%87Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINQ,FEES IST FL. SO. FT. ® $ UNITS A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SQ. FT. POR. SO. FT.® MOBILEHOME SVC. BAR SINK GAR. SQ. Ff. ® POWER OUTLET ROOF DRAINS CAR P. SQ. FT. DUCT WORK DRAINAGE PIPING WALL SQ. FT. GAS (ROUGH) DRINKING FOUNTAIN SQ FT. ® URINAL ESTIMATED CONSTRUCTION VALUATION $ REINF. STEEL WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ER SYSTEM 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/+ c SEWAGE DISPOSAL FIRE ZONE ROOFING SO.Fi.GAR ® 3/ac HOUSE SEWER FIREPLACE GAS PIPING PERMIT FEE SPARK ARRESTOR 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 L _ ' FORMS � 7(S �'� ER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. 6 GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT W TER HEATER SERVICE FINAL INSP. BOND BEAM ER SYSTEM $ GRADING cu. yd. plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING A�% jJ � REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL