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14516 (RPL)Tit P.O. BOX 1504 Building 78-495 CALLE TAMPICO Address 1--140 Calle «fie' Ion. a LA QUINTA, CALIFORNIA 92253 Owner Santa Fe Homan Mailing Address P.O. Box 450 City Zip Tel. 'La Quinta 1 92253 564-1866 Contractor Address La Quin:a 92253 564-1866 State Lic. City & Classif. 638535 1 Lic. # 859 Arch., Engr., Designer Address Tel. City IZip I State Lic. # ' LICENSED CONTRACTOR'S DECLARATION - 1 hereby affirm that I amrllcensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the`9usin6s and Professions Code, and my license is in full force.and effect. /14-4) r� i� i; :: t5 , 11,j, -!P— U • ep ;t� I hereby affirmlthat I,am exempt from the Contradtor's License Law for. the following .reason: (Sec. .7031.5, Business and Professions Code: Any city or county which requires a tru permit to consct, atter, improve, demolish, or repair any structure; prior to its issuance also requires the applkant for such permit to file a signed statement that he is licensed pursuant to the provision i of the Contractor'slicense Law; Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pro ,ns Code, or thathe is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by 'any- applicant f& a permit subjects the applicant to a civil penalty of not more than five hundred dollars (8500). ❑ 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 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 4nprove for the purpose of sale.) O 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 such projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. for this reason Date Owner ,y as WORKERS' COMPENSATION DECLARATION If 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 (8100) 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 Date Owner t NOTICE TO APPLICANT: tt, 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. WARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP. TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN'SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 -of this city -to enter the above-. mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip No. 3451& BUILDING: TYPE CONST. OCC. GRP. Number Legal Description Project Description Pool and St,a 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 Permit Validated by: ' Validation: Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $131,000.00 3 0nn0qn PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 93.60 Const. 1441.00 Mech. 24.00 Electrical 45.00 Plumbing 27.00 S.M.I. Grading Driveway Enc. , Infrastructure TOTAL 333.610 .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 Permit Validated by: ' Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBIW FE 1ST FL. SO. FT. ® $ UNITS UNDERGROUND G A.C. UNIT COLL. AREA SLAB GRADE YARD SPKLR SYSTEM C _ 2ND FL. SO. FT. p STORAGE TANK _ SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK FOUND. REINF. POR. SO. FT. ® METER LOOP HEATING (FINAL) OTHER APPJEOUIP. GAR. SO. FT. ® POWER OUTLET ROOF DRAINS GROUT DRAINAGE PIPING SERVICE CAR P. SO. FT. BOND BEAM WATER SYSTEM WALL SO. FT. ® GRADING cu. yd. $ Plus -X$-=$ DRINKING FOUNTAIN, LUMBER GR. SO. FT. ® FINAL INSP. URINAL FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ ROOFING WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER FIRE ZONE ROOFING VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL SPARK ARRESTOR FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM LATHING 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 CERT. OCC. SO. FT. ® c WATER HEATER FENCE FINAL MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 114 c SEWAGE DISPOSAL SO.FT.GAR ® 3/sc HOUSE SEWER 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 /4 UNDERGROUND G 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) �jr 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 lw�mqllor REMARKS: VENTILATION�� FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION 3 �/ CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL