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15826 (BLCK)Building Address '77-655 Calle P Owner Sterling R1'.ampas Mailing Address P.O. Box 450 City Zip La. Qiinta 32253 Contractor same as above 4 P.O. BOX 1504 78-495 CALLE TAMPICO �tTP_� lei LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. A.P. Number No. 15826 OCC: GRP. KJS •..�y� Legal Description Project Description 4611 Of 41 garden wall. City Zip Tel.: State Lic. & Classif.. City Lic. # Sq. Ft. No. .. No. Dw. t Size • Stories Units Arch., Engr., Designer NewXD Add ❑ Alter ❑ Repair ❑ ' Demolition ❑ Address Tel. City Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I,am licensed nder provisions of Chapter 9 (commencing with Section 7000) of Division 3 oUthe Busin.V. nd Professions Code, and my license is in full force and effect. > , !_; i 3 a s" 9, ; SIGNATURE •+� d P "7^/ -. J, .-,r DATE % 1 OWNER -BUILDER DECLARATIONs^, � I hereby affirm that I am exempt from the Contractor's License Law for the folTolving .reason: 7031. S,Buslness and Professions CodeAny city or county which requires a. Estimated Valuation q ! 3vG • Ori I - PERMIT AMOUNT permit to construct, alter, improve; demolish, or repail/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 ",4 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 Ove hundred dollars ($500). ❑ 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 or 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 bu11d or knprove for the purpose of sale.) Plan Chk. Dep. Plan Chk. Bal. Const.Mn Mech. - ' Electrical Plumbing ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- 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) jicensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. 8 P.C. for this reason S.M.1. Grading Driveway Enc. Date owner 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 • ❑ Copy is filed with the city, ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATIONINSURANCE REMARKS ' (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 - -- rl r^ + I n\ / r �\ 1 NOTICE TO APPLICANT: rf• 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. ZONE: BY: Minimum Setback Distances: v �� II j' Front Setback from Center Line Rear Setback fromt ear Prop. Line WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANDSide SHALL' SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10(3,000), 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 informationis 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 purposes. FINAL DATE Issued by: Validated by: Street Setback from Centef_Llne. r r Side Setback from Property Line INSPECTOR Date Permit Signature of applicant— Date Mailing Address Validation: ' City, State, ZIp CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING; FEES �Q• 1ST FL. SQ. FT. p $ 2ND FL. SQ. FT. p' POR. SQ. FT. p GAR. SO. FT. p CARP. SQ. FT. p WALL SQ. FT. p SQ. FT. p ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT 'NALL FLOOR SUSPENDED OTHER APP./EQUIP. LAUNDRYTRAY AIR HANDLING UNIT CFM TEMP. POLE I IKITCHEN 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. p c BATH TUB SO. FT. p c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID p 11/4 c SEWAGE DISPOSAL / + SQ.FT.GAR p 3/ac HOUSE SEWER REMARKS: GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL —OTAL FEES MICRO FEE MECH.FEE PL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTUFE 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) 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 ROOFIIIG FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL