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05640 (BLCK)Building 54-021 CORTEZ Jim Farctall Mailing Address Sam P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 La Quinta 1--92253 Contractor Chvwrlftilder Tel.' & Classif. I Lic. # Arcn., tngr., Designer Address Tel. City IZip I State Lic. # LICBISEID CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 700 01 Division 3 of the Business and Professions Code, and my license is in full force and SIGNATURE:N' DATE OWNtc VMMDM DECLARATION liljsireby affirin that 1 am exempt from the Contractors License Law for the following reasglr. afar, 7031.5.lkrsiress and Rdesadus Coda: Airy city or county which requires a .rem—* to _oorutrmre4 iaproae, danta0ah, or repair any aftuchoe. Prior to its issuance also remdhes the apPtfcard for such permit to eb a sighted statement that he is licensed pursuant to the prowt>(arms of the Contractor's Lieause lam Chapte 8 (Commencing with Section 7000) of Division, 3 d the Bushasa and Prortesatorts Code or that. he Is exempt Mershom, and Ore balls for the alleged exemption. Any rdclaffDo of section 7031.5 by 'any applicant for a permit auAjaets the app/cant ro a civf pertafy of not more titan fie hramrbed do8ats ❑ I, as owner of the.,pmperty, or my employees with wages as their sole compensation, will do eadons and the structure Is not intended or offered for`sale. (Sec. 7044, Buisness and Pro/easbna Code: Are ConWai . Lkense Law does .not apply to an owner of property who 6ir11de a dmproves Marson and who does such work himself or through his own employees, provided lost such igproraments are not [Wended or offered for safe. It, however, the bulfd[rg or Improvement is sold withs one year of cWVf don. the owner-buWar Wa have the burden of proving that he did not build or kWrove for the purpose of sale.) ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con - struet the project (Sac. 7044, Business and Professions Code. The Contractor's License Law does not apply to an owner of property who builds or wWrroves thereon, and who contracts for such pro%ecta with a cmbarWs) fioerrsed Pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec _____ --A & P.C, for this reason wORKEFts, COMPENSATION DECLARATION - I Hereby affirm tftat 1 have,a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, labor Code.) Policy No Company ❑ Copy Is filed with the city. p Certified copy is hereby furnished. CERTIFICATE OF OMMPTION FROM WOR KERS' COMPENSATION INSURANCE (rft section need not be condAa[ed 9 the permit Is for one 'hundred dosars (6100) valuation or less.) 1 certify that in the performance of thg-work for which this permit is Issued, I shall not =t" ipersorr in any manner so as to become subject to the Workers' Compensation RL Date ft Olnler f .� N017CE TO APPL1CANP O 'aite mat!tpy Ods CertiTrate of Exemption you should become suf*ect to the Ikbefts' Compensation provisions of the labor Code. you must forthwllh campy with such provisions or Ods permit shell 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, Chit Code.) LeL.=rsders Name Inddraga This is a building permit when property filled out, signed and validated, and is subject to expiration it work thereunder Is suspended for 1811 days.. I certify that I: have read this application and state that the above information Is correct. I agree, top with all dry ordinances county enances and state laws relating to building t construction, and hereby authorize representatives '-of this city to enter the -above-. mentioned property for Inspection purpceas No. 05640 BUILDING: TYPE CONST. . OCC: GRP.• A.P..Number 774-191-001 ,Legal Description Project Description FALL: SyJCco & WMD MAKE 170 FM, 5^-6 FST H7GH Sq. Ft. Size No. No. Dw. Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ Estimated Valuation $3,114.40 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. f Const: Mech. Electrical Plumbing S.M.I. .02 Grading Driveway Enc. Infrastructure i TOTAL REMARKS 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 DATEIN,S14ECTTO�R Issued by: Date / Permit Validated by: Signature of applicant -Date— Moiling, ateMailing Address Validation:. City, state, zip CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® S UNITS SLAB GRADE ROUGH PLUMB. BONDING Y ARD SPKLR SYSTEM 2ND FL SO. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP GAR. SO. FT. @ POWER OUTLET ROOF DRAINS GAS (FINAL) TEMP. POLE DRAINAGE PIPING CAR P. I W. FT. ® GROUT WATER HEATER WALL SO. FT. ® FINAL INSP. DRINKING FOUNTAIN, BOND BEAM WATER SYSTEM URINAL SO FT ® =S LUMBER GR. ESTIMATED CONSTRUCTION VALUATION $ FINAL INSP. WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER VENTILATION GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FIRE ZONE ROOFING ' LAUNDRY TRAY AIR HANDLING UNIT CFM FIREPLACE 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 SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID ® 1 V4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/4c HOUSE SEWER GAS PIPING PERMIT FEE PERM R FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTUREPLUMBING 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 xi =S 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 SIGNATURESIINRIAIS GARDEN WALL FINAL