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08664 (BLCK)4 P.O. BOX 1504 Building78-105 CALLE ESTADO ?7�50 A�� Address Faro=do LA QUINTA, CALIFORNIA 92253 Owner ®$YO Citizens Ttmoetateat 'CfY Sditicm BUILDING: TYPE CONST. AddressP.O. Rax V City lZip or City jZip N o . 08664 _OCC: GRP. A.P. Number Legal Description TriAct 25237 Project Description AtiSt of At Uftrn4n,i"tV U-01 5i4R fat 3 n ro I. SARI ^f '41, ff tt i__c Gt State Lic. City & Classif. Lic. # 1245 Sq. Ft. No. Size Arch., Engr., Stories Designer J. F. Davidson New Qk Add ❑ Alter ❑ Address Tel. 346--5631 CityI Zip I State Palm Drr•> owt 922Fa(} 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, prior to its issuance also requires the applicant for such permit to rile 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 not 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 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 Prov' _that he did not build or improve for the purpose of sale.) EVII 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;kpply to an owner of property who builds or improves thereon, and who contracts for "?- iuch projects with a contractors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec. B. & P.C. I this reason Date j� ✓^ Owner � r x y 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. ❑ 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 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 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 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. Dw. Repair ❑ W Demolition ❑ Estimated Valuation 44, 526,fl0 ' PERMIT AMOUNT Plan Chk. Dep. Y ` Plan Chk. Bal. Const. Mech. -. Electrical Plumbing S.M.I. 3.15 Grading Driveway Enc. Infrastructure TOTAL 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: .� T s CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES',, ' 1ST FL. SO. FT. ® $ UNITS SLAB GRADE 2ND FL. S0. FT. BONDING YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR. SO. FT. ® DUCT WORK ROCK STORAGE GAR. $0. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APPJEOUIF. DRAINAGE PIPING CAR P. 50. FT. ® TEMP. POLE WALL SO. FT. GROUT DRINKING FOUNTAIN. SO. FT. ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES FINAL INSP ('(�� a WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER REMARKS: GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED , �� 26o' LAUNDRY TRAY AIR HANDLING UNIT CFM FIRE ZONE ROOFING 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 LATHING 10t SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac 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 S AIR COND. SOLAR SETBACK 0 GROUND PLUMBING 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 FOUND. REINF. �\ GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIF. 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 ('(�� a FRAMING _�� FINAL INSP. '1 cvC/9 ROOFING VENTILATION yCG¢GVi� .i�.kYZ�CsCi ��/��" / �i1 / " �Cvv �" -'! / e C/ (Id�Z"`% S 103"kd 1 (( &,d t—_ C� /bVL�df� I�C0.L�Dr �I [�•�j --[s-5 Alec..f O��P�(A4 f diC�Ytn/ fV J REMARKS: , �� 26o' ry, FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING 10t MESH INSULATION/SOUND Ff l FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL