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002257 (SATT)Building 80-536 � BIS Address Owner i l I P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 S=im cmw_ MY Mailing - Address 5-005 CbmIlwy Mph Drivie City Zip - Tel. � 92253 568-2 Contractor Address City Zip Tela State Lic. City & Classif.. 2(Mly) Lic. # 328 Arch., Engr., Designer 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 70 00) of Division 3 of the Business and Professions Code, and my license is in full force and effect.. SIGNATURP ! ° ( /� ? ? .•tr --•� ! DATE " °.OWNER•BUILDERDECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Sec. 7031.5,Business and Prole''ssions Code: Any city or county which requires a permit. to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for suchpermit to°lila a signed statement that -he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or Divisibn 3 of the Business and Professions Code, or that. he is exempt therefrom,' and'the basis for the alleged exemption. Any,Pviolation of Section 7031.5 by 'any applicant. for a permit subjects the applicant to a civil penalty of not more than rive 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. (Seca 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 or improve for the purpose or sale.) _ ❑ 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 or 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 • - 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'COMPENSATIONINSURANCE (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 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 Owner NOTICE TO APPLICANT: If, after making this Certificate of Exemption you should become subject to the 'Workers' Compensation' provisions or 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. r Signature of applicant_ 4 -t "7 " % - Date _ Mailing Address City, State, Zip f HARD COPY No. 002257 BUILDING: TYPE CONST. A.P._Number, Legal Description Project Description OCC. GRP. M, 'vim INUM 30 0 Phase aE Minimum Setback Distances: Front Setback from Center Line Mr, 2825 Sq. Ft. Size $ No. No. Dw. Stories Units New ❑X Add ❑ Alter ❑. Repair ❑ Demolition ❑ Side Setback from Property Line FINAL DATE INSPECTOR Issued by: Date 4-6-86 Permit Validated by: Estimated Valuation 7.30,'s0 PERMIT AMOUNT PI'an Chk. DO. - Plan Chk. Bal..�� Const. 63£1. 50 Meoh. Q1) Electrical_i Plumbing S. M.I..i Grading Driveway Enc. Infrastructure 2.noo.w TOTAL '3j a5_i 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 4-6-86 Permit Validated by: Validation: A 5 1 0 7 4 8 348517 CK CONSTRUCTION ESTIMATE NO. ELECTRICAL FEE: NO. PLUMBING FEES 1ST FL. SO. FT. ® $ 2ND FL. SO. FT. POR.SO. FT. ® GAR. SO, FT. ® CAR P. SO. FT. WALL SO. Fr. ® 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 LAB GRADE g' FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER WIRING/nA GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED ROCK STORAGE LAUNDRYTRAY AIR HANDLING UNIT CFM 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/a c SEWAGE DISPOSAL WATER SYSTEM SO.FT.GAR ® 3/ac HOUSE SEWER $ 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 R—OROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA LAB GRADE g' eOUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS EWER OR SEPTf� TJt KFtOUGH / WIRING/nA DUCT WORK ROCK STORAGE A�&OUND. REINF, y GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL G GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE INAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. plus x$ _$ LUMBER GR. INAL INSP. fpt�' Lz-FRAMING ,G..�L/—�j� a FINAL INSP. /(1 n a� 6 1 ROOFING i�C�� Dib��L VENTILATION t �• j £ 2 �O� ,� ..�� "� �(,iC REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL ((fi� Q-C4LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL tli 1 V M"J JILMA 1 UMtS/In11 I IAUk GARDEN WALL FINAL