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12412 (RPL)T4tyl 4 lwQ�rw Building 78-748 Bottlebrush Mr. & Mrs. Karmeligh Address Same City Zip Tel. La Quinta, i 92253 Contractorr�✓� Time Gilbe� / Il�/I % �Ii3is7� Addy Jw585 riichael Place Desert, CA 92260 1 ""360m State Lic.I & Classif. A'617723 OCC. GRP. Pool ce �ti10 # Front Setback from Center Line Arch., Engr., a Designer Sq. Ft. Size Address New ❑ Add ❑ Tel. P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City Zip State Lic. # % LICENSED CONTRACTOR'S DECLARATION I hereby aff Wh t I am licensed under provisions of -Chapter 9 (commencing with Section 000) of Divisl'on 3 of the Business. and P,F01fi✓ssilionss Cr de,,,.an/d my license is in full force and "effect. /:/j" .t yam, `p' fi^� s�/_✓7 �e7l f 1 moi/ SIGNATURE " 11.f✓ =✓ f" DATE � OWNER -BUILDER DECLARATION I hereby firm that I am exempt from the Contractors 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 I 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). j 01 1 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 ,r Professions Code: The Contractor's License Law does not apply to an owner of property who F,.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 I 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 improves thereon, and who contracts for I such projects with a contractors) licensed pursuant to the Contractor's License Law.) I ❑ 1 am exempt under Sec. B. & P.C. for this reason I Date Owner WORKERS' COMPENSATION DECLARATION I hereby a Ir that I have a certificate of consent to self -insure, or a certificate of Worker's C ante, or a certified copy thereof.( c. 380,0(or Cod 0 � .) No. y is Company } ,mC, Copfiled with t city. PolicB ❑Certified op is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the,performanbe of thg work for which this=permitsis.iss�d, I shall not ploy any person in any manner sous to become,subjectst&the Workers' Compe sation aws of Califgqrrnia. D to /i!' Al '�!O ner NOTICE TO APPLICANT. If, after "making; this,,, Wfil catec`of Exemption you should become subject to the Workers' Compensation_,proGisions`othe Labor Code, tyou,must forthwith comply with such provisions or this permit'shall be deemed revoked. �....� CONSTRUCTION LENDING AGENCY Ihereby 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 No. 12412 t BUILDING: TYPE CONST. A.P. Number Legal Description roject Description OCC. GRP. Pool Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line a Side Street Setback from Center Line Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 4' rear yard setback and 3' sideyard setback approved by Setback Adjustment 33-2.2. t Validation: Estimated Valuation s9 f 1300.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 70.20 Const. 108.00 Mech. 24.00 Electrical 45.00 Plumbing 27.00 S.M.I. Grading Driveway Enc. Infrastructure TOTAL 4. d(i REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line a Side Street Setback from Center Line w Side Setback from Property Line ? FINAL DATEI INSPER&OR Issued by: ' U ate ��JJ it Validated by: nrT 2 1 1993 t Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS UNIT COLL, AREA SLAB GRADE YARD SPKLR SYSTEM 2ND FL. SO. FT. BONDING HEATING (ROUGH) MOBILEHOME SVC. BAR SINK POR. SO. FT. ® SEWER OR SEPTIC TANK ROUGH WIRING GAR. SO. FT. p POWER OUTLET ROOF DRAINS GAS (ROUGH) DRAINAGE PIPING CAR P. I SO. FT. ® HEATING (FINAL) I WALL SO. FT. ® DRINKING FOUNTAIN SO. FT. ® TEMP. POLE URINAL ESTIMATED CONSTRUCTION VALUATION $ GROUT 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 GRADING cu. yd. $ plus x$ GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SPARK ARRESTOR SO.FT.GAR ® 3/ac HOUSE SEWER GAR. FIREWALL 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 e"in GROUND PLUMBING/t.19. ' 7 UNDERGROUND,I -q %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 FINAL INSP. GRADING cu. yd. $ plus x$ =$ LUMBER GR. FRAMING FINAL INSP. ROOFING /y� " lvSdh"'Te 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 e"in