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001944 (PLBG)TAh Building 49-786 X �.I DriveAddress Owner Mailing Address t City lZip ITel .. rA ouil1 92253 Contractor Aaaress P.O. Bac £65 j City' Zip iduo 92202 P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tela 341—.3629 No. 001944 BUILDING: TYPE CONST. OCC. GRP. A.P. Number Legal Description Project Description ' . . - Pax'"r.,i al w re -p . State Lic. City Minimum Setback Distances: & Classif.���� Lic. # Sq. Ft. No. No. Dw. Side Street Setback from.Center Line Size • Stories Units Arch., Engr., INSPECTOR Issued by: i Designer i New 9 Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. A3517 i2 10 1200 R i City Zip State Lic. # -. LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and i effect. Y .. 1 It ,.a�i :�•..f�1 SIGNATUREr - DATE - i OWNEWBUILDER DECLARATION Estimated Valuation j 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 ' permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to lila a signed statement that he is licensed pursuant to - PERMIT - 'AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, of that. he is exempt therefrom, and the* basis Any Section 7031.5 Plan Cihk.. Dep. - • for the alleged exemption. violation of .by any applicant -for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). •- Plan Chk. Bal. ❑ 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. Code: The Contractor's License Law does not apply 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.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 12.00 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. - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - - Grading 11I am exempt under Sec. B. 8 P.C. for this reason iDriveway Enc. Date Owner I 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.) Policy No. Company I ❑ Copy is filed with. the city. - .0 Certified copy is hereby furnished. I I CERTIFICATE OF EXEMPTION FROM ' WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation 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. Date Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the Workers' - Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 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.) 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 purpposes. Signature of applicant -`�� '� " Date Mailing Address ! ` City, State, Zip A i HARD COPY TOTAL ".OU REMARKS 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 by: Date 124"= -Permit ' Validated by: Validation: A3517 i2 10 1200 R CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. @ $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. Y ARD SPKLR SYSTEM 2ND FL. SQ. FT. HEATING (ROUGH) STORAGE TANK FORMS MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® DUCT WORK ROCK STORAGE GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS METER LOOP HEATING (FINAL) DRAINAGE PIPING CAR P. I SQ. FT. @ GAS (FINAL) 0 WALL SQ. FT. DRINKING FOUNTAIN SQ FT ® WATER HEATER URINAL ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation WATER SYSTEM FLOOR DRAIN MECHANICAL FEES GRADING cu. yd. $ -Plus-X$-=$ WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER FINAL INSP. 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. SQ. FT. ®c BATH_ TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL" LATHING SQ.Fi.GAR g 3/ac HOUSE SEWER MESH 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 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 APP./EQUIP. REINF. STEEL GAS (FINAL) 0 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 DE , B(9 7 " Aid REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE.FINAL INSPECTOR'S SIGNATURESIINITIALS. GARDEN WALL FINALE