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002481 (SATT)Building Address Mailing _ Address 75-005 City lZip Palm Besqftt Contractor ress 4 • P.O. BOX 1504 No. 002481 78-105 CALLS ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST: OCC: GRP. ry C]"b Diiva A.P. Number Tel. 92260 568.,.2928 Legal Description Project Description •G.A�- NMIE I C and Land Iq�gs DUypp• Plan 300 �}2 ///��CR .. So CityZip Tel. State Lic. City MiG 3971 & Classif.. mno Lic. # 32 Sq. Ft. ��.4 No. No. Dw. Size . Stories Units Arch., Engr.. Designer New L1,,p Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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. t `DATE SIGNATURE' �' ^1 �-_''r- - r 1 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation 044.00 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a !l permit' to construct, alter, Improve, demolish, orrrepair any structure, prior to its issuance also -PERMIT , requires the applicant for such permit to file a -signed statement that he is licensed pursuant to AMOUNT the provisions of the Contractor's License Law, Chapter .9 (commencing with Section, s7000).of 'Division 3 oftheBusiness'and'Professions Code, or thathe is exempt therefrom, anathe basis for the Section 7031.5 for Plan Chk. Dep. -. 250.00 alleged exemption./Any violation of .by any applicant a permit subjects the applicant to a civil penalty of not more than five hundred. dollars ($500): Plan Chk. BaI. - A99 2111 ❑ 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. .. Professions Code: The Contractor's License Law does not apply to an owner'of property who .who .i1_f ' s thdoes such work himself or through his own employees, . builds or improves and Mech. -i� that such improvements are not intended or offered for sale: If, however, the, building 11)6provided 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.) : - _ O 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing struet 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. '11 MA such projects with a contractor(s) licensed pursuant to 4he.Contractor's License Law.) Grading - ❑ I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date owner Infrastructure_ WORKERS' COMPENSATION DECLARATION hereby affirm that Ihave 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. . O Certified copy is hereby furnished. TOTAL 3.605.49 CERTIFICATE OF EXEMPTION FROM REMARKS 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 Owrier NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become ZONE: BY: subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked: - Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line CONSTRUCTION LENDING.AGENCY Side Street Setback from Center Line ' 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.)' Side Setback from Property Line Lender's Name Lender's Address ' FINAL DATE INSPECTOR, 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. 7-23-86 I certify that I have read this application and state that the above information is .correct. Issued by: Date Permit 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: l Signature of applicant Date /' - 1 Mailing Address ' = Validation: City, State, Zip Ab104 7 31 3b.,548 CK HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICALS NO. PLUMBING FEES IST FL. SO. FT. ® Iq P, 2ND FL. S0. FT. POR. SO. FT. ® GAR. SO, FT. ® CAR P. SO. FT. WALL. SO. FT. @ SO FT ® 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.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEOUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR Q 3/ac HOUSE SEWER REMARKS: VENTILATION 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 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 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 MbFLUI UM'b blUNA 1 UPItb11141I IALJ GARDEN WALL FINAL