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002226 (SATT)P.O. BOX 1504 Building 78-105 CALLE ESTADO Arl(1rasc LA QUINTA, CALIFORNIA 92253 Owner Mailing Address 75-005 oowxtxi Mvb D,. City Zip � Tel. palm wsext 9,2260 568-r2826 Contractor vftU M13iX Address City JZip r Tel State Lic. I City & Classif. 283130 Lic. # 326 ' Arch., Engr., Designer Address Tel. City Zip State Lic. #.... LICENSED CONTRACTOR'S DECLARATION I hereby affirm that Pam 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 1�1. 1.' y - ,f DATE r '^'OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following re..on:I(Sec. 7031.5,Business,and� Professions Code: Any city or county which requires -a permit to consirucl, alter, 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'nol more than five 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 of property who builds or improves thereon and who does such -work himself'or through his own employees, provided that such improvements are nol,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..)' ' ❑ 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.). O 1 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 ❑ Copy is filed with the city. . ❑ 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.) 1 certify that in the performance of thg 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 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 in spection'purposes. Signature of applicant !r %- Date_ Mailing Address City, State, Zip HARD COPY No. 002226 BUILDING: TYPE CONST. OCC: GRP A.P. Number Legal Description PM WW, X400 Project Description MaSS .6 B B1.99 3142 Sq. Ft..No. No. Dw. Size- � Stories Units New © Add ❑ Alter ❑ Repair ❑. Demolition ❑ Estimated Valuation 19i, 9.00 PERMIT AMOUNT Plan Chk. Dep. Plan .Chk. Bal. 564.19 Const. 6,70.00 Mech. 55.00 Electrical M.65 Plumbing 14€3.50 S.M.I. 13.83 Grading Driveway Enc. Validation: Infrastructure 2,000.00 --A5120• 4 8 358 1) TOTAL t 60.17 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 4'7-86 Permit Validated by: Validation: --A5120• 4 8 358 1) CONSTRUCTION ESTIMATE NO. ELECTRICAL IEFlilli NO. PLUMBING FEES 1ST FL. SQ. FT. ® 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. FT. WALL SQ. FT. ® SQ. 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER %fJUGH WIRING �� rMMEETER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROCK STORAGE LAUNDRY TRAY AIR HANDLING UNIT CFM LOOP 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 SERVICE SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL WATER SYSTEM SO.FT.GAR ® 3/ac HOUSE SEWER $ Ic GRADING cu. yd. plus x$ 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 /2 ROUND PLUMBING 10 Me UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE DOUGH PLUMB. 6 BONDING HEATING (ROUGH) STORAGE TANK / '/FORMS `��� f / L v ER OR T %fJUGH WIRING �� rMMEETER DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) LOOP HEATING (FINAL) OTHER APPJEQUIP. pa h%REINF. STEEL �� GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ Ic GRADING cu. yd. plus x$ _$ LUMBER GR. FINAL INSP./v 10IRG FRAMING �J66 o yA7 ,/IC FINAL INSP. ROOFING �j.0 CC77 C� �j REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING e 6 MESH ULATIONISOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL Y(a.V WA // Ally/kms /Z,&_