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08276 (RPL)Building Address •f 4 P.O. BOX 1504 } N o . 78-105 CALLE ESTADO rj % LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC. GRP. Mailing Address pre Vk—Ip A.P. Number City up ane Tel. T� fi.*tn Legal Description Project Description Ciii iA FI r Pool 14 so* Contractor 1t4.. r.. Address sFRead City Zip Tel. PA1Vt ap-Vin" 922" 32"546 State Lic. City & Classif. Lic. # Sq. Ft. Size No. No. Dw. Stories Units Arch., Engr., Designer New WX Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. A"I g32 - 6565 City a Zip State Lic. # 2264 1 1,416534 ft RICe ENSED CONTRACTOR'S DECLARATION I hereby affirm that I amIicensed`under provisions of Chapter 9 (commencing with Section 7ffec of Division 3 of the Busipdss and Professions Code, and my license is in full orce and ,effect. �/� T61 • TURE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation /fAn nqAq 18ft?Ot?��+/ 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 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 PERMIT AMOUNT Plan Chk. Dep. 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). O I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 122- Is Const. MAO 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 Mech. 24.0 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 Electrical 45.00 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.) Plumbing 22-110 ❑ 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 S.M.I. 1-94 such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & 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.) Poll c111YNo. company r tvir•,t� f7py is filed with the city. O Certified copy is hereby furnished. j}�� TOTAL 409-11 REMARKS CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation �� } i H�► _ s R `k7AV {Y 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. ,r r•r s . w . " 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 FINAL DATE INSPECTOR 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 sof this city to enter the above- mentioned property for inspection purposes. Issued by: Validated by: Date Permit Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS COLL, AREA 2ND FL. SO. FT. YARD SPKLR SYSTEM POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS CAR P. I SO. FT. DUCT WORK DRAINAGE PIPING WALL SO. Fi. DRINKING FOUNTAIN, SO FT ® HEATING (FINAL) URINAL ESTIMATED CONSTRUCTION VALUATION $ Q 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 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GRADING cu. yd. $ —plus—x$_=$ LAUNDRY TRAY AIR HANDLING UNIT CFM 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 FIRE ZONE ROOFING: SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/a c SEWAGE DISPOSAL SO.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 PLUMBING t7 UNDERGROUND C. f(o 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)B(2 Gj Z- METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL Q GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM FINAL INSP. �/j GRADING cu. yd. $ —plus—x$_=$ LUMBER GR. FRAMING FINAL INSP. ROOFING ^ �o C � 1 REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL �/ ��j (G INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL