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10087 (BLCK)Budding 53-8.25 WA©ARRO Owner WILLIAM BAKER Mailing Address 51510 RUBIO P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 City I Zip Tel. . LA Q:3IN A .92253 564-21787 Contractor OWNER BUILDER,- Address UILDER' Address City' Zip Tel.: State Lic. City & Classif.. Lic. # i ;.Arch.; Engr.,• Designer >.� Address Tel. City Zip State i; Lic. # LICENSED CONTRACTOR'S DECLARATION Y�.. I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and.Professlons Code, and my license is in full force and yrs 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 'y 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 ision 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). 1, 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 IxAds 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 improve for the purpose of sale.) O I, as owner of the property, am exclusively contracting with licensed contractors to con- stRlct 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.) ' 0 1 am exempt under Sec. B. & P.C. for this reason Date" //- ] l �f e`r Owner l ,-T !i Ilk k 1-+ 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 certi 'a� cop there_ofrySe 3900, Labor Code.) . Policy No. Com any " isa a�(D_ P Copy is filed with the city. O Certified copy is hereby furnished. 1 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.) 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 Calmfornia. Date --Owner NOTICE To APPLICANT: g, 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. " 1.0081 BUILDING: TYPE CONST. OCC: GRP. A.P. Number ,Legal Description Project Description BLOCK WALI.L280 t % 51 Sq. Ft. No. No. Dw. Size Stories Units I. New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ z'{' ate, r=te Estimated Valuation $bQEbG as PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. $90.00 Mech. Electrical Plumbing S.M.I. 070 Grading Driveway Enc. Infrastructure TOTAL.' REMARKS LI 'r a' L A 60, 'J.@. 0 { ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback fron.RearProp. Line Side Street Setback from Center Line Side Setback frors Property Line FINAL DATE INSPECTOR Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SQ. FT. ® $ UNITS A.C. UNIT 2ND FL. SQ. FT. ® SLAB GRADE YARD SPKLR SYSTEM POR. SQ. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS CAR P. SO. FT. ® DRAINAGE PIPING WALL SQ. FT. ® DUCT WORK DRINKING FOUNTAIN. SQ. FT. ® GAS (ROUGH) URINAL ESTIMATED CONSTRUCTION VALUATION $ HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL WATER PIPING NOTE: Not to be used as property tax valuation TEMP. POLE FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM. FAN.-- EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE _ DRYER WATER SYSTEM GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED $ LAUNDRY TRAY AIR HANDLING UNIT CFM LUMBER GR. KITCHEN SINK ABSORPTION SYSTEM B.T.U. TEMP USE PERMIT SVC WATER CLOSET' COMPRESSOR HP POLE, TEM/PERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER. B.T.U. SO. FT. ® c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1% c SEWAGE DISPOSAL SQ.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 & 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 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 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND FINISH GRADING FINAL INSPECTION - CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL