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05128 (MFD5)T4hf 4 4 a" Building Address 7.8-195 Crimson Drive Boulevard Development:*_ . Mailing AddreN7 S. Main City ore$ste P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 No. 05128 BUILDING:- TYPE CONST. OCC: GRP. A.P. Number 613--790-010 805Legal Description Project Description Ruildinq 36. Flnn 23!r_ T,nte 342 Address .s City Zip Tela State Lic. City & Classif. 31126i Lic. # 1177 Sq.,Ft. 912 No. No. Dw. r Size - Stories Units Arch., Engr., Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address a Tel. City, Zip State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) off Division 3 of the Business and Professions Code, and my license is in full force and effect - r SIGNATURE ' >- -DATE . OWNEWBUILDER DECLARATION Estimated Valuation I hereby affirm that I am exempt from the Contractor's License Law for the following $65,225 reason: (Sec. 7031.5,Bushess and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, prior to its Issuance also requires the appicant for such permit to rile a signed statement that he is licensed pursuant to PERMIT AMOUNT the provisions of the Contractors License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Bussness and Professions Code, or that. he is exempt therefrom, and the bass section 7031.5 'any for Plan Chk. Dep. for the alleged exemption. Any violation of by applicant a permit ' subjects the applicant to a civil penally of not more than rive hundred dollars ($500). Plan Chk. Bal. O I, as owner of the property, or my employees with wages as their sole compensation, will q ,� do the work, and the structure is not Intended or offered for sale. (Sec. 7044, Busness and Const. Professions Code., The Contractors 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. provided that such improvements are not intended or offered for sale. ff, however, the building or hnprovement is sob within one year of completion, the owner -builder writ have the burden Electrical of proving that he did not build or improve for the purpose of sale.) 44- ' ❑ I, as owner of the property, am exclusively contracting with licensed contractors to corn Plumbing 00 ' struct the projecL (Sec. 7044, Business and Professions Code: The Contractors License Law _ does not apply to an owner of property who builds or improves thereon, and who contracts for S.M.1. such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) Grading ❑ 1 am exempt under Sec B. & P.C. for this reason Driveway Enc. Date Owner Infrastructure 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, Labor Code.) Policy No Company ` ❑ Copy is filed with the city. ❑ Certified copy is hereby furnished. TOTAL $2,272.71 CERTIFICATE OF EXEMPTION FROM REMARKS WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation t A ljitri i'... ,]. f;t -� {+';• :'� �t^.✓� �1 ^� �,. -. r f 0 or less.) I certify that in the performance of the work for which this permit is issued, I stall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: lf, after making this Certificate of Exemption you should become sutaject to the workers' Compensation provisions of the Labor Code, you must forthwith comply 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.) Lender's 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 certity that I have read 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 ZONE: BY: Minimum Setback Distances: Feont Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE 12NYPPE�CJO�Ra Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SO. FT. ® $ UNITS COLL. AREA 2ND FL SO. FT. YARD SPKLR SYSTEM BONDING MOBILEHOME SVC. BAR SINK POR. S0, FT, ® 00, SEWER OR SEPTIC TANK GAR. SO, FT. ® POWER OUTLET ROOF DRAINS n FOUND. REINF. f �� lv % v GAS (ROUGH) DRAINAGE PIPING CAR P. SO. FT. ® OTHER APPJEGUIP. REINF. STEEL WALL SO. FT. GAS (FINAL) DRINKING FOUNTAIN. SO FT ® URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER HEATER WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SYSTEM WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER ROOFING VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUNDS FINISH GRADING FINAL INSPECTION'S CERT. OCC. FFNr:F FINAI 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 ® 1% c SEWAGE DISPOSAL SO.FT.GAR @ 3/ic HOUSE SEWER 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 PLUMBIN ELECTRICAL HEATING 8 AIR COND. SOLAR SETBACK ot GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ! ( ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS 00, SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE n FOUND. REINF. f �� lv % v GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEGUIP. 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. ` �! L L FRAMING CA INSP.' D YI000 ROOFING VENTILATION FIRE ZONE ROOFING ' FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUNDS FINISH GRADING FINAL INSPECTION'S CERT. OCC. FFNr:F FINAI / /�In l REMARKS: SIGNATURES11NITIALS GARDEN WALL FINAL