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05821 (PLBG).` f T4hf 4 sep P.O. BOX 1504 N o. 05821 Building 78-105 CALLE ESTADO Address 79_ 104 EIGENA VMURA LA QUINTA, CALIFORNIA 92253 Owner 11 +.C.R. ASSOCIATES BUILDING: TYPE CONST. OCC. GRP. Mailing Address P.111. BOX 5132 A.P. Number City Zip Tel. 1 A 0+u `A 0,2253 564-3692 Legal Description 7??-1 ?�ill''�A � A Contractor Project Description'~� Address AROLD rAERT SyS7-CmM /rydJ7 3U--640 AMME 40 � �. %� r�� ellpL City 1'iP92201 Tel. �UI7ut T)MIE5 343--4746 State Lic. City & Classif. 2r-1229 5 Lic. # Sq. Ft. No. No. Dw. Size Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter (commencing with Section 7000e 1 of Division 3 of the Business and Professions Code, and my license In full force and effect. SICaP:A7l1AE DATE OWNER -BUILDER DECLARATION Estimated Valuation I hereby affirm that'll am exempt team the Contractor's License Caw for the following reason: (Sec. 7031.5,Suvriess and Professions Cade' Any cAy or county which ri ggwres a permit to pbnstrucf, after, improve, demolish.: Or repair any struclum, odor 10 Its issuance Also requires the applicant (OF such permit to file a signed statement that he Ls Ncansed pursuant to PERMIT AMOUNT the provistons of the Contractor's License Law, Chapter 9 fcornmenckm0 with Sechnm 7000) of 0i'vision 3 of the Business and Profassions Code, or that he fs exempt therefrom, and the basis W the aNegod exemption. Any vialaflon of Section 70aT.5 by any 3WVcanf ter a permll Plan Chk. ❑ep. strb)acls the applicant to a chat ponafty of not more than live hundred dollars ($500). fi I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. do the work, and the structure is not intended or offered for sale- (Sec. 7044, Buisness and Const. Profosslons Code: The Contractor's License Law does not apply 10 an owner of property who builds or enprovas thereon and who does such work himself or through his own employees, Mech. provided that such knprovmrrments are not intended or offered for safe. 11. however, the bu#ding or knprovement is sold wlfhM one year of completion. the ownar•buNdar will have the burden Electrical of proving that he did not build or improve for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struct the project. (Sec. 7044, Businoss and Professions Code_ The Contractor's License Law does nol apply to an owner of property who builds or improves thereon. and who conlracls for S.M.I. such projects with a corlfractoffs) licansad pursuant to the Confraclor's License LawJ Grading ❑ I am exempt under Sec. B. & P.C. for this reason Driveway Enc. Date owner Infra . t ucture WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to sell -insure, or a certificate of Worker's Compensation Insurance, or a certified copXil(eof. (Sac. 3600, Labor Code.) . t� r Policy No. Company _ ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that to 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 CatifDmia. Date Ownor . NOnCE TO APPLICANT: If, after making lhis Cerfdfcate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Minimum Setback Distances: comply wfth such provisions or lhls parmil shall be deemed revoked. 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 or which this permit is issued. (Sec. 3097, C"Code.) Side Setback from Property Line Lender's Name Lender's 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. 31 —01 89 I certify that I have read this application and state that the above information is correct. Issued by: Date_tefITiit 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 - men tioned property far inspection purposes. Validated by: Signature of applicant Date Mailing Address. —Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO. FT. FINAL INSP. WALL SO. FT. ® WATER SYSTEM DRINKING FOUNTAIN, GRADING cu. yd. $ plus x$ =$ URINAL SO FT ® FINAL INSP. FRAMING ESTIMATED CONSTRUCTION VALUATION $ 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 FIRE ZONE ROOFING GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIREPLACE 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. SO. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE !ELECT SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR GOND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND 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 GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING 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 1