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06471 (SFD)Building T4hf 4 4 a" P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Owner I La Quinta Azoociate$ Address 43-875 wTashl City izip Contractor I E. 0. Willi=S Dov. Corp. Tel. SCytate 493941t1 Licit. # 1231 Arch. Eng Designer Address Tel. City I Tip I State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 affirm Unat 1 am iced oder provsiars d Chapter 9 (commencing with Section 7000 di ion 3d the Business aM Pro(essiore Code, and my license is in full force and e!{ecL Sii—WTrfE DATE Ot•11ER4RMJ R DECLARATION I hiseby aN'ign that 1 an eme pt icor. the Contractors License Law for the following nsaor . (Sec. 7OOt-5� and F1d�essima Codw Any city or county which requires a pans? In aaamr I alts r , denw I In or repair any structure. prior to its issuance also relies the Meant for sm:6 perrrnI to 4 a sipled statement that hes licensed pursuant to The pray — of the Qmlaceur'S Lserse taw, Chapter 9 (commencing with Section 7000) of 6vWm 3 at the tib and Rabs9va Code, or that. he is exempt therefrom, and the basis /or the alleged e>®pfox Any wohfer of Section 7031.5 by any applicant for a permit siEjectt Be atter b a aripemty of nd mre than fee hudred dofars (5500). 0 1, as owner of the property, or my employees with mages as their sole compensation, will do the want and the sbrrrltle is not or offered for sate (Sec. 7044, f3uisness and Aufessiea Code The Carrrar� Lke se Law does not apply to an owner of property who bride or igows /mrean and dno does such work himself or through his own employees, prorrided tot sir iwproneme� am not kdermbd or offered for sale. ll, however, the building err i¢asar I is mold win one ar d yeeoepletion, the owner -budder will have the burden ofprori{q EW he didnot how or Aupiurre for Ore pupose of sale.) 0 k as owner of the property, am exclusively eontmcting with licensed contractors to con- struct the project_ (Sec 7040, Husimm and Rofessio s Cade: The Contractor's License Law does nap aPPry b an omrer d property wbo hulls or ixproves thereon, and who contracts for such pratjecls vii a oorOrrJorjs,j tcersedprwsraY [o the Contractors License Law.) 0 1 am eT®rpt oder Sec R E P.C. for this naso Date owner wORKERS' CONP®SATION DECLARATION 1 hereby affirm that 1 have a certificate of consent to self -insure, or a certificate of wakens Compensation I nswaroe. or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No Company 17 Copy is tied with the city. 0 Certified copy is hereby furnished. CERMICATE OF EXEMPTION FROM wOld COMPENSATION INSURANCE saca n need not be complalled i fie pom it is for one hundred ddars ($100) valuation or AMM) 1 certify that in the performance of the wok 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 at Caifornim W07X3= 70 APFLCAMr- f, altar ■olig Otis Ceafhae of Exemption you should become sutl ct b e Nbrim ' Cmpeosdm pro.ltrs d iothe Labor Code, you must forthwith comply wib Or srdr prate or the peed shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affrtm that there is a construction lending agency for the performance of the wak for which the permit is issued (Sec. 3097, Civil Code.) Lenders Mare Lenders AdA�s This is a buddig permit where properly filled out, signed and validated, and is subject to e:p- .. it wak thereunder is suspended for 180 days. I certify that 1 have read this app8rab n and state that the above information is correct. 1 agree to comply with all city and county orlinarces and state laws relating to building eauctiart and heer rby authorize repverratines of this city to enter the above- , , sod property for r PaPase y Sgrxatu e al anniunl Date Main9 Address Q ly. stark cin No. 06471 ILDING: TYPE CONST. OCC. GRP. P. Number Tract 22982 Phrase III Legal Description_ Project Description Plan 5C8 Lot 66 Sq. Ft. 2134 a No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ REMARKS .�,t1;.,.�t1:•t'll 1' (trt(�t _ z ,..rl�.... 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 1013!89 Issued by; Date Permit Validated by: Validation: Estimated Valuation $113,413 PERMIT AMOUNT Plan Chk. Dep. \ Plan Chk. Bal. $ 570.32 Const. 588.54 Mech. 53.50 Electrical 120.17 Plumbing 138.50 S.M.I. 7.98 Grading Driveway Enc. Infrastructure 2:551.79 TOTAL $4.130.75 REMARKS .�,t1;.,.�t1:•t'll 1' (trt(�t _ z ,..rl�.... 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 1013!89 Issued by; Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS SLABGRADE ,(J �/ r/� ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® AS (ROUGH)1q4e ETER LOOP GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) MP. POLE DRAINAGE PIPING CAR P. I SQ. FT. ® GROUT WATER HEATERSERVICE WALL SQ. FT. FINAL INSP. DRINKING FOUNTAIN. BOND BEAM WATER SYSTEM URINAL SQ FT ® =$ LUMBER GR. FINAL INSP eG0 7/ ESTIMATED CONSTRUCTION VALUATION $ ROOFING (Z VENTILATION r FIRE ZONE ROOFING' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING/9 IV �66 MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. 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 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1+/. 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 A4, SETBACK f C77 GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLABGRADE ,(J �/ r/� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. ,j�e r ' AS (ROUGH)1q4e ETER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL GAS (FINAL) MP. POLE GROUT WATER HEATERSERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP eG0 7/ FRAMING I �� FINAL INSP. ROOFING (Z VENTILATION r FIRE ZONE ROOFING' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING/9 IV �66 MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. N /" REMARKS: SIGNATURESIINITIALS GARDEN WALL FINAL