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003026 (SATT)Building Address 55-506 Pinehurat Owner Mailing Address 75 -MI S Cafmtry clyp% T) City Zip . . Palm. Vess4 . 92260 Contractor mila=1 mart axe and Address P.O. BOX 1504 No.0 0 '3026 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tel. -568-8628 City Zip Tel: State —Lic. City — .& Classif. U8130 Lic. # 328 Arch., Engr., Designer Address Tel. City lZip State Lic: LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commen*cing with,Section 7000) of Division 3 of the Business and Professions Code, and.my license is in full,force,ind effect. SIGNATURE f DATE OWNER -,BUILDER DECLARATION 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, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant forsuch 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 ($500). * ... 0 1 as owner of the property, or my, employees with wages as their sole compensation, will do ihe 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 improvesthereon and who does such work himself or through his own employees, prov-lded 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 or improve for the purpose of sale.) 0 1, 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 contractor(s) licensed pursuant to the Contractor's License Law.) 0 1 am exempt under -Sec. . B. & P.C. for this reason DateOwner WORKERS' COMPENSATION DECLARATION ✓ I hereby affirm that V have a certificate of consent to self -insure, or a certificate of Worker's Compensationl�surance, or a certified copy, thereof. (Sec.3800, Labor Cdde.) Policy No. .Company 0 Copy is filed with the city. 0 Certified copy -is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed it the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of thip work for which this permit is issued, I shall not employ any person in any manner so as to become subject, to the'Workers' Compensation Laws of California. 'Date_Owner NOTICE TO APPLICANT. If, after making this Certificate of Exemption you should become subject to the ' Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. - I certify that I have read this application and state that the above -information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip' HARD COPY BUILDING: -TYPE CONST. OCC*. GRP. A.P..Number Legal Description Project Description PGA West Phase 4B Plan 30 MR W-0 2825 Sq. Ft.w No. No. Dw. -Size Stories Units. New EX Add 0 Alter El Repair 0 Demolition 0 ZONE: BY: Minimum Setback Distances: Front,$etback'from Center Lin Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR* Issued by:. —,Date 4-2-87 Permit Validated by: Validation: B 7 6 5 7552.43 it Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. ,Plan Chk. Bal. Const.- Mech. Electrical 171i -71 Plumbing x -'so S.M.I. Grading Driveway Enc. Infrastructure 2000-00 TOTAL Als 52 IAA REMARKS ZONE: BY: Minimum Setback Distances: Front,$etback'from Center Lin Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR* Issued by:. —,Date 4-2-87 Permit Validated by: Validation: B 7 6 5 7552.43 it CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. 2ND FL. POR. GAR. CAR P. WALL ESTIMATED CONSTRUCTION VALUATION SQ. FT. ® $ UNITS ( SQ. FT. YARD SPKLR SYSTEM SO. FT. ® MOBILEHOME SVC. BAR SINK SQ. FT. ® POWER OUTLET ROOF DRAINS SQ. FT. DRAINAGE PIPING SO. FT. DRINKING FOUNTAIN SQ. FT. ® URINAL $ WATER PIPING NOTE: Not to be used as property tax valuation HEATING (FINAL) FLOOR DRAIN MECHANICAL FEES GAS (FINAL) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE i DRYER WATER HEATER GARBAGE DISPOSAL FURNACE UNIT WALL 3 FLOOR SUSPENDED FINAL INSP. LAUNDRYTRAY AIR HANDLING UNIT CFM WATER SYSTEM KITCHEN SINK ABSORPTION SYSTEM. I 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 SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL 1 SQ.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 STRUCTURE I ' PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR /1/WE BACK ROUND PL1. jVINR>-1q UNDERGROUND A.C. UNIT COLL. AREA k(,�LAB GRADE 7 �T - S� OUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS I EWER OR SEP K OUGH WIRING -3 G D DUCT WORK ROCK STORAGE FOUND. REINF. AS (ROUGH) - .; METER LOOP HEATING (FINAL) OTHER APP./EQUIP. �REINF. STEEL /.� Vlllc GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM �. WATER SYSTEM $ GRADING cu. yd. plus x$ _$ LUMBER GR. 1 NAL INSP. %Q �� RAMING INAL INSP.`()_ '� � i00FING}7�"s 'Z(� ✓1 a tv,!/.%ee '/ / C c/� Il.AeL -�(f^O / - REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE ' SPARK ARRESTOR GAR. FIREWALL L(45 -LATHING MESH 1 t geINSULATIONISOUND FINISH GRADING i IeFINAL INSPECTIONlG� CERT. OCC. FENCE FINAL .. INSPECTOR'S SIGNATURESIINITIALS 1 GARDEN WALL FINAL