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003544 (SFD){ Building Address 53-665 Bemudas Owner Mailing Address P. 0. Box 1379`- 'r City Zip Contractor Address State Lic. & Classif. Arch., Engr., Designer Address P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 003544 BUILDING: -TYPE CONST. OCC: GRP.- A.P. Number 774-135-020 43--2671 Legal Description Project Description Single Family Dwellinq Sq. Ft. 1812 No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 92276 1 343-267 City Lic. # el. 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` i/& .. r . ./ -/i ,% _. SIGNATURE r - - - DATE ` OWNEWBUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following x93. reason: (Sec. 7031.5,Susiness and Professions Code: Any city or county which requires a 1 i3 6c8 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 Professions Code, or that. he Is exempt therefrom, grid the basis Any Section 7031.5 'any for - Plan Chk. Dep. - for the alleged exemption. violation of by applicant a permit subjects'ihe applicant to a civil penalty of not more than five hundred dollars ($500). .$250.01D - C 2 Plan Chk. Bal. , , 109.52 ❑ 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 COrlst. 415.00 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. 36�� 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 84.1S 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 127.00 Strutt 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.I. 6.55 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading 20.00 O 1 am exempt under Sec. B. & P.C. for this reason Driveway Enc. 20.00 Infrastructure 2,075.58 Date owner WORKERS' COMPENSATION DECLARATION ' I hereby affirm that'[ 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. TOTAL $3,142.80 CERTIFICATE OF EXEMPTION FROM REMARKS y WORKERS' COMPENSATION INSURANCE j (This section need not be completed if the permit is for one hundred dollars ($100) valuation - or less.) .. . I certify that in the performance of the work for which this permit is issued, .1 shall not 'hit 'I employ any person in any manner so as to become subject to the Workers' Compensation IV (, 4i, t i rt i fit_ I ,-c r G . Ov Laws of California. .1 ,} Date Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become ZONE: BY: _ ' subject to the Workers' Compensation provisions of 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 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 I. Lenders 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. 12/29/87 I certify that I have read this application and state that the above information is correct. Issued by: Date Permit 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. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip HARD COPY T ' CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ UNITS SLAB GRADE 1i '' � ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. ® FORMS// SEWER OR SEPI TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK FOR. SQ. FT. @ GAS (ROUGH) METER LOOP GAR. SQ. FT. @ POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SQ. FT. @ GROUT WATER HEATER WALL SO. FT. @ FINAL INSP. DRINKING FOUNTAIN SQ. FT. @ WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE: Not to be used as property tax valuation ROOFING ^DC VENTILATION W FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL j THING MESH FLOOR DRAIN MECHANICAL FEES REMARKS: WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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 SQ.FT.GAR @ 3/ac HOUSE SEWER 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 PLUM IN _ UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 1i '' � ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS// SEWER OR SEPI TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. 'Z16 (( GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. S 2 GRADING cu. yd. $ plus x$ _$ LUMBER GR. FRAMING 1 / FINAL INSP. ROOFING ^DC VENTILATION W FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL j THING MESH 1�� L �— '( Il` y �G� YJ 1 REMARKS: INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL GARDEN WALL FINAL