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05800 (RPL)P.O. BOX 1504 Building 78-105 CALLE ESTADO Address 54-021 CORVEZ LA OUINTA, CALIFORNIA 92253 Mailing Address SAME City ITi Contractor City & Classif. I Lic. # Arch., Engr., Designer Address Tel. City Zip State Lic. # LICENSED CONTRACTORS DECLARATION I hereby I awn licensed under provisions of Chapter 9 (commencing with Section 3 of the Business and Professions Code, and mylicense is in full force and aff SIGNATURE DATE OMINEWMILDER DECLARATION I hereby alHgn that 1 am exempt: from the Coritrector's License Law for the following reasons (Sec. ,703t.5Jbshess aro Prdeswons. Code: Any COY or couny Which requires a per- to construct aMer, home. dernoBsh. or repair any structure, prior to Its Issuance also =dres the app3card for such pemd to Me a signed statement that he sGcensed punusnt to Ore prertalonq d fee CoMacNr9 License Law, Chapter 9 (conmrembg with Section 7000) of Dh4slon 3 of the Business and ftfessions Code, or that. he Is exempt `fherdmm, and the tresis for the aDig, exeirption_ Any violodan of Section 7031.5 by 'any applicant for a pannit subjected* eDpdcant to a chdpeaallyof not more than five hundred dottars ($500): ❑ 1, as•owner of the property, or my employees withwagesas their sole compensation, will t=do the work and the structure is not Intended or offered for sale.. (Sec. 7044, tindsness and WW= The Contract" License Law does not appy to an owner of property who bid* wlaproves thenecn and who does such wok himself w through his own employees, provided tis! such irpror®nmlfs are not 6Nended or offered for ads. N, however, the building or Hignt roment is sold wffd one year of corrydafbn. the owner -budder will have the burden of proving that he did notbuild or frnorove for the purpose of sale.) ❑ I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the prajecL (Sec. 7044, Business and Professions Code: The Contractor's License law does not appy to an owner of property who builds or inptoves thereon, and who contracts for such pn* m with a cerdracoWs) Ecersed pursuard to the Contractor's License Law.) D lam exempt under b P.C. for this reason Date - Owner WORKERW COMPENSATION DECLARATION 1 thereby affirm that 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 Na Company EI Copy Is filed with the city. ❑ Certified copy is hereby fumished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be cornuted If fire pend! Is for one hundred doges ($100) valuation or lass-) I certify that in the performance of the work for which this permit is Issued, 1 shall not employ arty person in arty manner so as to become subject to the Workers' Compensation Laws of C alifornia_ Date Owmlen' NOTICE TO APPLICANT: M, after makirg' this Certilicate of Erempum you should became Srrbipcf to the Workers' C001pe safforr' provisions of the Labor Code, you must forthwith coaply with proiilslans or this peraWshall be dearned rewked: CONSTRUCTION LENDING AGENCY I. hereby atfirm,that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097. Cud Code.) Larders Name Larders Address This is abuilding permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 189 days. Icertify Me�partrI1p Ihyere read tis application and state, that the above Information is correct. l agree to alyd wit all fifth and acuity ordinances and state Taws relating` to building o onstrudion, and hrereby auUrorize re0recentaHves of Mis city to enter the above-. merdiorled propeAy tar tnspection purposes. - Sigrrahrre of applicant Date Mailing Adidas City,- State, Zio No. 05800 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 774-191-001 Legal Description Project Description POOL Sq. Ft. No. No. Dw. Size Stories Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation ,$9,000.00 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 108.00 Const. 70-20 Mech. 24.00 Electrical 30.00 Plumbing 27.00 S.M.I. .63 Grading Driveway Enc. Infrastructure TOTAL ,� �• a 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 DATE INSPECTOR Issued by: Date 5/19/89 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SQ_ FT. ® $ UNITS COLL. AREA SLAB GRADE ROUGH PLUMB. YARD SPKLR SYSTEM 2ND FL SQ. FT, HEATING (ROUGH) STORAGE TANK POR SO FT ® MOBILEHOME SVC. BAR SINK GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. GAS (ROUGH) DRAINAGE PIPING CAR P. I SQ. FT. HEATING (FINAL) OTHER APPJEQUIP. WALL SQ. FT, @ GAS (FINAL) DRINKING FOUNTAIN. SQ FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER HEATER WATER PIPING NOTE Not to be used as property tax valuation FINAL INSP. FLOOR -DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.COOL I HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED FINAL INSP. LAUNDRY TRAY AIR HANDLING UNIT CFM U �� 4✓`U + 5� /� 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B-T.U. SO. FT. RESID ® 114 c SEWAGE DISPOSAL SQ.FT.GAR ® 3/4c HOUSE SEWER LATHING GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE PLCK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK 011 ROUND PLUMEIIN40-749 UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK 10 �iOUGH 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 $q GRADING Cu. yd. —plus—x$—=$ LUMBER GR. FINAL INSP. FRAMING FINAL INSP. ROOFING U �� 4✓`U + 5� /� �— �/o �i� 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