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15145 (AR)- •Y l • P.O. BOX 1504 Building' 78-805 Pina 78-495 CALLE TAMPICO Address LA QUINTA, CALIFORNIA 92253 Owner ' Mr. & Mrs'."Jack Bra1y Mailing Address 78-805 Pina 9 Quinta Z'p 92253 Tel. V VIIl141.1V1j}q�� y y�y�yAy�p. //tltl q I V.L. 'S48i.vens Const. 260 Pinyon Creat City"' Zip Tel.: tin• Canter 1 92561 349-3327 State Lic. 521353. City 312 & Classif. . Arch., Engr., Designer P. Anderson Address Tel. 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 effect. SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,Businass and Professions Code: Any city or county which requires a• permit to construct, after. Improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed statement that'he is licensed pursuant to 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 subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ 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 Professions 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, 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 of proving that he did not build orlmprove for the purpose of sale.) O _I, as owner of the property, am exclusively contracting with licensed contractors to corn 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 such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ I,am exempt under Sec. B. & P.C. for this reason Date Owner 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 O Copy is filed with the city, O 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 ($ 100). valuation, or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ anyperson in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT.- ff, after making this Certificate or 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. BUILDING: TYPE CONST Number No. 15145 OCC: GRP. — Legal Description Garage Addition Project Description 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 3706 OF THE LABOR 'CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when property 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. Issued by:_ 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. Validated by:_ Signature of applicant -Date- Mailing ateMailing Address Validation. City, State, Zip 1 ZONE: BY: 'Minimum Setback Distances: Front Setbact0rom Center Line Rear SetbackfromRear Prop. line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR it Sq. Ft. Size 33`6 No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation*t§J•e�5 • PERMIT AMOUNT Plan Chk. Dep.. Plan Chk. Bal. Const.' •. Y �- Mech. Electrical • •'- Plumbing 5 •OF S.M.I. Grading Driveway Enc. Infrastructure TOTAL • REMARKS 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 3706 OF THE LABOR 'CODE, INTEREST, AND ATTORNEY'S FEES. This is a building permit when property 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. Issued by:_ 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. Validated by:_ Signature of applicant -Date- Mailing ateMailing Address Validation. City, State, Zip 1 ZONE: BY: 'Minimum Setback Distances: Front Setbact0rom Center Line Rear SetbackfromRear Prop. line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR it CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. SQ. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK FOR. SO. FT. ® _ ROCK STORAGE GAR. SO. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEQUIP. DRAINAGE PIPING CARP. SO. FT. TEMP. POLE WALL SO. FT. GROUT DRINKING FOUNTAIN SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation -$ FLOOR DRAIN MECHANICAL FEES FINAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED 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. SQ. FT. ® c BATH TUB GAR. FIREWALL SQ. 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 INSULATION/SOUND GAS PIPING PERMIT FEE FINISH GRADING 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 APPJEQUIP. 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 INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL