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003536 (RPL)..-r Building Address Owner Mailing Address Cjty 44 P.O. BOX 1504 78-102 San `'x®ec78-105 LA QUINTACC.CALIFORNIA 92253 . Moelter J__A -"_U11 r_R Contractor Cali. Address City Cathedral Zip ITel. Pools & 5na Tela 922a 323""_7303 No. 003536 BUILDING: TYPE CONST. .00C: GRP.- A.P. Number 617-330-0.25. Legal Description Project Description P6,61 .Spat . ' State Lic. City & Classif.. 185102 Lic. # Sq. Ft. No. No. Dw. _ Size - Stories - Units Arch., Engr.; - .. . Designer New ❑ • Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City .f' 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. . _SIGNATURE 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, alter, improve, demolish, or repair any structure, prion 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 Divisfon' 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). O 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 or properly who Estimated Valuation ��.�r• _► s •• PERMIT , AMOUNT ' r.� Plan •Chk: Dep. . Plan Chk. Bal. $71.92 ' Const. - Mech. - �� • 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 Electricalj�0(E . • 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.) Plumbing ij . (; ❑ 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 of property who builds or improves thereon, and who contracts for S.M.I. 1.02 - such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. -- B. ti P.C. for this reason Grading Driveway Enc. Date owner Infrastructure WORKERS' COMPENSATION DECLARATION ' .l 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 _ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE :REMARKS (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 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. ; U t_.f3�: fS i t(t r,L :t L.a.Y . ' q Date ' Owner ' NOTICE TO APPLICANT.- It, 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. - ZONE: BY: ' Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line 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.) Side .Street Setback from Center Line ----.;-- Side Setback from Property Line Lender's Name FINAL �D nECTO ECTO - �ATE INSPECTOR 2 Lender's Address 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. 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 sof this city to enter the above- mentioned property for inspection purposes. Issued by: Validated by; Date Permit - Signature of applicant Date Mailing Address Validation: T City, Slate, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FE93 IST FL. SO. FT. ® $ 2ND FL. SQ. FT. ® POR. SO. FT. ® GAR. SO. FT. ® CAR P. SQ. 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 ROUGH PLUMB. FLOOR DRAIN MECHANICAL FEES HEATING (ROUGH) WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER DUCT DUCT WORK GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED GAS (ROUGH) LAUNDRY TRAY AIR HANDLING UNIT CFM HEATING (FINAL) 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. SO. FT. ® c BATH TUB BOND BEAM SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL LUMBER GR. SQ.FT.GAR ® 3/ac HOUSE SEWER FRAMING FINAL INSP. GAS PIPING PERMIT FEE PERMIT FEE I 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 PLUMBIN -G UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK UGH WIRING DUCT DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP./EQUIP. 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 P��_ Uu��i r5-l� ta���— ,r2�v REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL UM'J bmr4A 1 UNtJI1N1I IAL,_ GARDEN WALL FINAL