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03939 (AR)Building)bSiQ SiUB'C3 Address Owner DaVid VaSgUez TAh 44Q P.O. BOX 1504 78-105 CALLE ESTADO % LA QUINTA, CALIFORNIA 92253 Mailing Address Sam City Zip FT_e_ l. La Ouirita 922,53 Legal Description Mntdeiw and closet addition Project Description CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (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 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 REMARKS r ,r" 1r{ f t10 ru4} +StrRs�� ail ^f4�—flak n a atr IA 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 5/16/89 Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOL0E1109D • A88E66OR'S OFFICE, HARD COPY - FILE City Zip Tel. State Lic. City & Classif. Lic. # Sq. Ft. No. No.'Dw. Size Stories Units ' Arch., Engr.,: ' Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 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 Estimated Valuation $7,670 670 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a +� , permit to construct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed sta.ement that he is licensed pursuant to PERMIT AMOUNT 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 Any Section 7031.5 by 'any for Plan Chk. Dep. alleged exemption. violation of applicant a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 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 Const. 6 a• 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. Mech. provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion. Me owner -builder will have the burden Electricals s ti of proving that he did not build or improve for the purpose of -sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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 contractor(s) licensed pursuant to the Contractor's License Law.) S.M-I. Grading ❑ 1 am exempt under Sec. B. 8 P.C. for this reason I Driveway Enc. Date ti 11111 r Owner - �� LCZ-_ f �. !�� '� rf!f f� "� Infrastructure r WORKERS' COMPENSATION DECLARATION 11./ I hereby affirm that I have a certificate of consent to self -insure, or a certificateo` f Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy NO. Company 0 Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (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 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 REMARKS r ,r" 1r{ f t10 ru4} +StrRs�� ail ^f4�—flak n a atr IA 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 5/16/89 Permit Validated by: Validation: WHITE - FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOL0E1109D • A88E66OR'S OFFICE, HARD COPY - FILE CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO FT h f UNITS SLAB GRADE ROUGH PLUMB BONDING Y ARD SPKLR SYSTEM 2ND FL SO- FT. tS FORMS SEWER OR SEPTIC TANK POR SO FT Cr MOBILEHOME SVC BAR SINK GAR SO. FT. Cr POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APP.IEOUIP. DRAINAGE PIPING CAR P. FT. � SO TEMP. POLE WALL SO FT. a GROUT DRINKING FOUNTAIN SO. FT. rB FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION S WATER SYSTEM WATER PIPING NOTE Not to be used as property tax valuation =f FLOOR DRAIN MECHANICAL FEES F[NAL INSP. WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASH ER(AUTOXDISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 GAR. FIREWALL SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID T'A c SEWAGE DISPOSAL SO.FT.GARsg 3/4c 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 f FENCE FINAL STRUCTURE PLUMBING ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK 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 APP.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING Cu. yd. f plus xf =f LUMBER GR. F[NAL INSP. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURE&INITIALS GARDEN WALL FINAL 7d DESERT SANDS UNIFIED SCHOOL DISTRICT NOTICE: THIS DOCUMENT CA.ed1Hcahway sizoi1 BE DUPLICATED, , TO: CERTIFICATE OF SCHOOL FACILITY FEE WAIVER This is to c rtify that , developer of , which is located at — - , within this school district, s not equired to pay school faci ity fees pursuant to the authority generated by Government Code Section 53080. Building permits for the project indicated above may now be issued by your jurisdiction. IF VALUATION INDICATED ON BUILDING PERMIT EXCEEDS $20,000 THIS WAIVER IS VOID AND A SCHOOL F C_ Ej TIES FEM TT E PAID PRIOR TO ISSUANCE OF BUILDING PERMIT. l DESERT SANDS UVIFIED SCHOOL DISTRI White -Building Department Yellow -Facilities Planning Pink -Developer (10)-38 ,R