The URL can be used to link to this page

05130 (MFD5)T4'y4 4 Q" Building Address 78-217 Crimson Drive P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 Mailing Address 777 S. Y iyt St., Suit 06 City Zip Tel Civls.tnn a[i9f,itf, i3b�.fiit7..Atlfirt Contractor City lZip Tela State Lic. I City & Classif. 331261 Lic-9 ..117Z., Arch., Engr., Designer Address I Tel. CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I 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 1 am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,13usress 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 We a signed statement that he is licensed pursuant to the provisions of the Cartractors License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for the alleged exeng on. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a circ pedally of not more than five hundred dollars ($500). ❑ 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 Contractors License Law does not apply to an owner of property who bi 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. ff, 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.) ❑ I, 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 owner of property who builds or improves thereon, and who contracts for such projects wdn a contra tors) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Workers Compensation Insurance, or a certified copy thereof. (Sec. 3800, tabor Code.) Policy No Company O Copy is filed with the city. ❑ Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sermon need not be completed If the permit is for one hundred dollars ($100) 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: C, after making this Certificate of Exemption you should become subject to the Workers' Compedsaiion provisions of the Labor Code, you must forthwith corrpy 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.) Lenders Name Lenders 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 rte 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 LDING: TYPE CONST. No. OCC: GRP. P. Number 05.30 Description t Description 'A1_-1 I4 Jv;o '%A - Pgon 7X!9 Lat Q4'! I Sq. Ft. 912 Size' No. Stories No. Dw. Units' New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $68,225 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. 'j. I _alb Mech. Electrical AA.76 Plumbing 75,00 S.M.I. a o Grading Driveway Enc. Infrastructure 1,467.57 Fringe—Toad L,.zar€Y 38.18 TOTAL t2_272.71 y REMARKS ` Aflrl, A 2--lb-MR, io >}. it' �.•tt.) tY R + tr x rtr. s +.X t r. • t .w 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 12/28/88 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL SO. FT. ® $ UNITS UGH PLUMB. BONDING 2ND FL SO. FT. STORAGE TANK YARD SPKLR SYSTEM SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SO. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) GAR. Sq, FT. ® POWER OUTLET ROOF DRAINS DRAINAGE PIPING CAR P. I Sq. FT. FINAL INSP. WALL SO. FT. WATER SYSTEM DRINKING FOUNTAIN. SO FT ® LUMBER GR. URINAL 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 GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRY TRAY AIR HANDLING UNIT CFM 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 ® 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® V4c HOUSE SEWER FINAL INSPECTION GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE EPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING se UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE UGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. Z 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. FRAMING3 y gam-- FINAL INSP. ROOFING ' REMARKS: VENTILATION FIRE ZONE ROOFING: FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING qv MESH INSULATIONISOUND`3/'1 FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL