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9945 (PAT)r T44 4 - � P.O. BOX 1504 No. 994.5 Building 78-105 CALLE ESTADO r;. Address 54-075 Juarez LA QUINTA, CALIFORNIA 92253 C Owner Joseph and Paula Cool Mailing BUILDING: TYPE CONST: OCC: GRP. Address same- A.P. Number City Zip Tel. LG Quinta 1 92253 IW- Legal Description Contractor {%joe ; Project Description Patio COVer ©t>3her%Builder Address City Zip Tel.: State Lic. City & Classif. Lic. # Sq. Ft. No. No. No. Dw. Arch.; Engr., Size Stories Units 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 EStlmatcd Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following 2535. 20 reason: (Sec. 7031.5,Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair anystructure, prior to its issuance also. AMOUNT ' requires the applicant for such permit to rile a signed statement that he is.licensed•pursuant to PERMIT 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 .Plan Chk. Dep. subjects the applicantto a civil penalty of not more than rive hundred dollars.(S500). +Plan Chk. Bal. 5 e R I; as. owner of the property, or my employees with wages as their sole compensation, will 10 do the work, and the structure is not intended or offered .for sale. (Sec. 7044, Buisness and Const. 5 (a• ' Professions Code: The Contractor's License Law does not apply -to an owner• of property who 0-0 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: 8, however, the building or improvement is sold within one year or completion, the .owner-builder will have the burden Electrical - of proving thathe 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 or 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.) - - ❑ I am exempt under Sec. B: 8 P.C. for this reason Grading A n- Driveway Enc. Date Owners f~f:t.f„?drr - i' 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 S ❑ Copy is filed with the city: ❑ Certified copy is hereby furnished. TOTAL • 4f CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This sectionneed not be completed g'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 a'IA f W) W) 4601! employ any person in any manner so as to become subject to the Workers' Compensation Laws of talitornia. -t✓; / r -1 V' t, 444 L i i1 i RL. A *fiY Date ownei /� i - { e .' ,_S. t 6169 NOTICE TO APPLICANT: If, after making this Certificate' of Exemption you should become. 'ZONE: BY: subject' to 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, Civil Code.) Side Setback from Property Line Lender's Name Lender's Address FINAL DATE INSPECTOR This is a building peimit 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. Issued by: Date Permit 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. Validated by: Signature of applicant Date Mailing Address Validation: City, State, Zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SO. FT. ® GAR. SO. FT. ® CAR P. 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 SLAB GRADE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROUGH WIRING. GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRYTRAY AIR HANDLING UNIT CFM GAS (ROUGH) KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEWPERM LAVATORY HEATING SYSTEM- FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SQ. FT. ®c BATH TUB WATER HEATER SQ. Fr. ®c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1% c SEWAGE DISPOSAL BOND BEAM SQ.FT.GAR ® V4c 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 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 APPJEQUIP. 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 INSSSP.// ROOFING •�2�j�'l�si,� ®/ � / 9� A/�` REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION 10 CERT. OCC. I FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL