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002397 (BLCK)Building -Address 531^ Owner Mailing, Address w City Zip Contractor w�� Address P.O. BOX 1504 No. 002397 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Tel. 92M 564-64 4. . BUILDING: TYPE CONST. OCC: GRP:- A.P. Number Legal, Description Project Description ,.. City Zlp Tel,.. State Lic. City & Classif. • Lic. # Sq. Ft. No. No. Dw. Size Stories -Units Arch., Engr., .... .. ...... ...... - - Designer New O� Add 0 Alter O Repair 0 .. Demolition O Address Tel. 7Q.. A ft. of 6— highWWd fewe CityZip State _,. Lic. # LICENSED CONTRACTOR'S DECLARATION . _ 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 .applicantfor. such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Sectiow.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 or Section 7031.5- by 'any applicant for. a. permit " subjects the -applicant to a civil penalty"of nol'more than five hundred dollars ($500). -- ' O 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 toan 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, W 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 or sale.) ... Estlrrtated V11U8tlOn ..�' . -.-PERMIT , AMOUNT Plan Chk.� Dep. Plan.Chk. Bal:. - _ Const.. Mech. - ' Electrical - - Plumbing 0, 1, 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 ownerof 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 his reason - `,l'✓' .. S.M.I. . . - Grading . r Driveway Enc. ' -w ..Date Owner,%+10.'"� ,.rr'-„�^"r Infrastructure _ WORKERS' COMPENSATION DECLARATION • I hereby affirm'thaYl 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. O.Certified copy is hereby furnished: TOTAL4.ti V CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE .. REMARKS'. (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, 1 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, t0' the Workers' Compensation .provisions of the'Labor' Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - ' ZONE:' BY: ' Minimum Setback - . Front Setback from Center.Line . ” .. Rear Setback.from Rear Prop.,Line 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.) • Side Street Setback from Center Line Side Setback from, Property,Lirle 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., . er' 'I certify that I have read this application and state that -the aboveinformation.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 i� Date Mailing Address �''i! '• ` FINAL.DATE •:•ISSUed by:' " Validated by: Validation: _ A 5 7 3 6 INSPECTOR Date P,ermlt b 5 20,00 CK _... . City, Stare, Zip HARD COPY CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SQ. 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 lax valuation SLAB GRADE FLOOR DRAIN MECHANICAL FEES BONDING WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED DUCT WORK LAUNDRY TRAY AIR HANDLING UNIT CFM GAS (ROUGH) 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 WATER HEATER SQ. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 11/e c SEWAGE DISPOSAL BOND BEAM SQ.FT.GAR p 3/ac HOUSE SEWER GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBLTOTAL 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 INSP. ROOFING DECMESH 17 1987 REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS, GARDEN WALL FINAL