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15407 (SATT)P.O. BOX 1504 No. 15407 Building 78-495 CALLE TAMPICO Address 0" � �s">il'Ltd Se WeS�6t 13r. C LA QUINTA, CALIFORNIA 92253 Owner— E.G. Williams Development Corp BUILDING: TYPE CONST. VN OCC: GRP..X21 Mailing Address 42-000 Crook St. Suite 128 A.P. Number City Zip Tel ' " Lot 1 Tract 28019 Palm Desert, C� 92,211 (619) 341-6880 Legal Description ContractorSrA — Apartment Plat 1 Sane Project Description Address Senior HOUSing .et The Seasons City. Zip Tel.: State Lic. City & Classif. S 49399 Lic. # 1231 Sq. Ft. No. No. Dw. Arch., Engr., Size .689 Stories Units Designer Stoffgren Fuller Associates New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. 68-487 E. Pala Canyon (61911328-1801 _ ityState C�athedra1 C$tY,Zi92234! Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7(X10) of Divisions 3 off the Business and Professlons,Code, and my license�.is.in full force.and SIGNATURE t DATE r OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following Estimated Valuation $311r424.00 reason: (Sec. 7031.5,Susiness 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,file a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) or 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 applicant to a civil penalty of not more than five hundred dollars ($500). R o8©. ❑ I, as owner of the property, or my employees with wages as their sole compensation, will Plan Chk. Bal. 1 do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and COf1St. 297.50 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. �ge �i� provided that. such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year or completion, the owner -builder will have the burdenElectrical -7 82 of proving that he did not build or improve for the purpose of sale.) + ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 108-000 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 S.M.I. 3.14 - such projects with a contractor(s) jicensed pursuant to the Contractor's License Law.) Grading 2O ®� O 1 am exempt under Sec B. & P.C. for this reason Driveway Enc. .00 Date Owner Infrastructure 70774 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.) Poy No. Company Copy is filed with the city: ❑ Certified copy is hereby furnished. TOTAL 1,535.18 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (8100) 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. N, 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. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL -FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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.. 1 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 ZONE: BY: Minimum Setback Distances: Front Setback from Cente Rear Setback from Rea . Line Side Street Setback Ce ter L1 Side Setback frooperty FINAL DATE INI z —^n Issued by: Date_ Validated by: rmit CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBINIG SEES 1ST FL. SO. FT. ® $ 2ND FL. SQ. FT. p POR. SO. FT. ® GAR. SO. FT. ® CAR P. SO. FT. WALL SO. FT. ® SO. 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 BONDING FLOOR DRAIN MECHANICAL FEES FORMS 3 9� WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED OTHER APPJEQUIP. LAUNDRY TRAY AIR HANDLING UNIT CFM TEMP. POLE 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 FINAL INSP. vv 7/ SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3hc HOUSE SEWER VENTILATION FIRE ZONE ROOFING 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 PLU UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE 6�? S ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS 3 9� EWER R SEPTROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. /Q GAS (ROUGH ETER LOOP HEATING (FINAL) OTHER APPJEQUIP. REINF. STEEL �Q 3 GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. vv 7/ FRAMING 20 �� FINAL INSP. ROOFING L/9� ��G IW120110 ���G/9/� J REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND 96 FINISH GRADING d FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS GARDEN WALL FINAL