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002785 (AR)} P.O. BOX 1504 ..No. 00,ice7X71`5 Building�� itl1�J 78-105 CALLE ESTADO Address LA QUINTA, CALIFORNIA 92253 Owner T'wodb idr on Mailing :' BUILDING: -TYPE CONST. OCC: GRP.- ' AddressSam A.P. Number City Zip Tel. - �• • ia Al . 92253 Legal Description Contractor . . <.. Project Description Address 75-231 Pa� ' " them City.. _ Zip -Tel.. a __.. IrAlan W8 93210 ... . _ State Lic. City & Classif. •Lic. # Sq. Ft. No.- No. Dw. �` Size ••Stories Units -Arch., Engr.,. ,. Designer,New ❑ Add Alter❑ Repair ❑ : Demolition 0 Address Tel. _ City Zip State Lic. #.. LICENSED CONTRACTOR'S DECLARATION_ I hereby aft rmr that I am licensed under provisions of. Chapter 9 (commencing with Section - + 7000) of Divis'lon 3°of�the Business and Professions Code, and my license is in full force and effect. . _.J( r3 i - .. .. ._ . SIGNATUREY DATE , , •. - ,.. _ � . OWNER -BUILDER DECLARATION Estimated Valuation ° �VVAA•�� Ihereby 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, 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: PERMIT - ' • • • AMOUNT' the provisions of the Contractor's License Law, Chapter 9 (commencing with. Section ,7000) of - twston 3 o .the Business and Pro/es—ns 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 Plan.Chk. Dep. ... - - .- ' subjects the applicant to a civil penalty o/ not more'fhan five hundred dollars (3500)." . - - . Plan Chk', Bal. '., • ❑ 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'• COW.*.'Z" • Professions Code: The Contractor's. License Law does -not apply to o/ property:who•.. • builds or improves thereon and who does such work himself -or through his own employees, 'provided •Meeh., �y+� /�I/f� that such Improvements are not intended or o/fered'for sale. If, however, .the building' or improvement is sold within one year o/ completion, the owner -builder will. have the burden Electrical • "-' .13.00 20.00 o/ proving that he did not build or improve /or the purpose o/ sale,)- ❑ I, as owner of the property, am exclusively contracting, with licensed contractors to con- Plumbing• 00 • 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 ' S.M.I. • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) •- Grading •. ❑ 1 am exempt under Sec. B. & P.C. for this reason % 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 3".02 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS'_ COMPENSATION INSURANCE (This section need not be completed If the permit is for one hundred dollars (S 100) • valuation - orless.)......-._ .. .. certify that in the performance of ft 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 ' ZONE: - BY: ' ' subjectto 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 •' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civa Code.) "' Side Setback from .Property Line Lender's Name 1 Lender's Address AFI -NAL DATE INSPECTOR ` 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. -Issued by: Date '""'Permit: agree to comply with all city and county ordinances and state laws relating to building - construction, .and hereby authorize representatives -sof :this city to - enter the - above-. - - - - mentioned property for inspection purposes.' +� i• Validated by: Signature of applicant Ri r ••- r •� Date t ^t -I', K-�, Mailing Address Validations City, State, Zip I _ A70-35 12 31 b81,2 11 HARD COPY z CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ, FT. ® CARP. 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 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 APP./EOUIP. 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/4 c SEWAGE DISPOSAL 2 SQ.FT.GAR ® 3/ac HOUSE SEWER 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 SETBACKG D PLUMBIN 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 CFOUND. REINF. _ GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP.% +//•d BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus —X$_=$ LUMBER GR. INAL INSP -f7- 7 MING 2 qjg!5 ^ FINAL INSP. _ S ROOFING 2 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL HING Z '�i 3/ MESH LATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL