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15111 (PAT)44 f P.O. BOX 1504 Building,78-495 CALLE TAMPICO Address 44--125' CAMINO LA.VW.rJA LA QUINTA, CALIFORNIA 92253 Owner . City, Zip Tel. L�..QQINTA 92253 Contractor Address 45--82 4&fA3. Chamaerop Pala Lin. City lZip Tel.: State Lic. & Classif Arcn., Lngr.;. Designer Address . City Lic. # Tel. No. 151.1 BUILDING: TYPE CONST. OCC: GRP. A.P. Number Legal Description Project Description Pati© Cover Sq. Ft. Size ,-6 New ❑ No. No. Dw. 5€3sCy Stories Units _ Add ❑ Alter ❑ Repair 0.,' Demolition ❑ City Zip State Lic. # 'LICENSED CONTRACTOR'S DECLARATION I`hereby affirm that I licens under provisions of Cha ter- (commencing with Section 7000) of Di�js�on�3/of�th Busine s and-FrofeSpions Code, my y license is in full force and i• . �! i DATE - ' OWNER -BUILDER DECLARATION �l EStlmdted V81UatlOn877-8.00 8 7 f'8 a 0 0 I hereby affirm that I am exempt from the Contractor's License Law for the following - reason:,(Sec. 7031.5,Business and Professions Code: Any city or county which requires a Y 'r permit to construct• after, improve, demolish, or repair any structure, prior to its issuance also the for to rile that he is licensed to- PERMIT AMOUNT - -: requires applicant such permit a signed statement pursuant 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 for the alleged exemption. Any violation of Section 7031.5 by 'any applicant for a permit�9 Plan Chk. Dep. subiects the applicant to a civil penalty of not more than five hundred dollars ($500). - Plan Chk. BBI. �2 I .6 ❑ 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 Const. -108.00 -Professions Code: The Contractor's License Law does not appy to an owner of property,'who - . - builds or improves thereon and who does such work himself or through his own employees, Mech. ` 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 . of proving that he did not build or improve for the purpose of sale.) - p'1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 'struct the project. (Seca 7044, Business and Professions Code: The Contractor's License Law ' improves for S.M.I. does not apply to an, owner of property who builds or thereon, and who contracts such projects with a contractors) licensed pursuant to the Contractor's License Law.) .88 Grading ❑ I am exempt -under Sec. B. 8 P.C. for this reason Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION Yive ti ation Pett ' I hereby -affirm that I have a certificate o{consent to self -insure, or a certificate of WorkePs Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company M Cnnv Is filed with the city ❑Certified copy is hereby furnished - CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need 'not' be completed If the permit is for one hundred dollars (S 100) valuation • or less.) I certify that in the performance of thp'work for hich this permit is iss h, shall not employ any person in any manner so as WIN %subjgct to/he Workers'M",pensation ` Laws of li(omia 2 C ?! 4t Date fish Owner f i � NOTICE O APPLICANT: ff, after making this Certificate of Exempton you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provfslons or this permit shall be deemed revoked. WARNING: FAILURE -TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370.6 OF THE LABOR CODE, INTEREST, AND. ATTORNEY'S FEES. This is a buildingpermit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that -the above information is correct. 1 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 • City, State, Zip TOTAL 1 1 287.08 REMARKS An rl"tnvestication for startlnq ;W0 --r-1 charged ner 1991 UBC 3 14 (e) 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 Issued Validab Validat CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST 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 GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I SO. FT. GROUT WATER HEATER WALL SO. FT. FINAL INSP. DRINKING FOUNTAIN SO. FT. ® WATER SYSTEM URINAL ESTIMATED CONSTRUCTION VALUATION $ _$ WATER PIPING NOTE: Not to be used as property tax valuation FINAL INSP. FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED VENTILATION LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE 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 LATHING 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 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 -T STRUCTURE PLUMBING ELECTRICAL HEATING 6 AIR COND. 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 �I 1 FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING InA FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIONATURESIINITIALS GARDEN WALL FINAL