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05148 (MFD5)Titif 4 4 a" Building Address 78-191 Crimson Drive- Owner rive-Owner . Boulevard DeveloAmant Mailing Address777 q- 'dinIn St., City Zip Tel. Or At% etas Q76467 ~t► Contractor P.O. BOX 1504 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST No. OCC: GRP. P. Number 6 i i-79in—n i n w54—RO f� Legal Description Project Description An,l s 4 n w AS av% It, µ T -a t 14(% State Lic. City & Classif_ 31 126 t Lic. # 1177 Sq. Ft. 763 No. Size Stories No. Dw. Units Designer or New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State Lic. # ,h. LICENSED CONTRACTOR'S DECLARATION I hereby affirm that 1 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.` ! 7 SIGNATURE' �'" r•.. • Y ..-• e S ,ATE OWNMBUILDER DECLARATION I hereby affiryn that I am exempt from the Contractors License Law for the following reason: (Sec. 7031.5,113usiness and Professions Code: Any city or county which requires a permit to construct, after, improve, demolish, or repair any structure, pdor to its issuance also requires the applicant for such permit to fie a signed statement that he is licensed pursuant to the provisions of the Contractors 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 exemption. Any violation of Section 7031.5 by 'any applicant for a permit subjects the applicant to a civil penalty of Trot more than rive 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 builds or improves thereon and who does such work himself or through his own employees, provided that suchrrmprovements are not intended or offered for sale. If, 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 safe.) ❑ 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 with a contractors) licensed pursuarnt to the Contractor's License Law.) ❑ 1 am exempt under Sec B. & P.C. for this reason Estimated Valuation PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. - $ 251.81 Const. 304. 40 Mech. O 3.00 j Electrical1 w 78 Plumbing 63.00 S.M.I. 3.96 Grading Driveway Enc. Date owner Infrastructure 1,279,94 Friaee-Toed lizard 38.18 WORKERS' COMPENSATION DECLARATION I hereby affirm that 1 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.) Policy No Company ❑ Copy is filed with the city. ❑ Certified copy is hereby fumished. CERTIFICATE OF EXEMPTION FROM WORKERS, COMPENSATION INSURANCE (This section need not be completed ff the pemuil is for one hundred dollars ($100) valuation less TOTAL $2,111$.67 REMARKS �r L � ���?< X t' } is •; ', � �T i3 4 r'.� �'� -1 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 aliforniaDateOwner NOTICE TO APPLICANT: ft, after mW&V this Certificate of Exemption you should become subject to the workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions Of this Pam* 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 it work thereunder is suspended for 180 days. I certify 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: 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: Datel 2 / 28 % 8 BPermit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL. SQ. FT. ® $ UNITS COLL. AREA 2ND FL SO. FT. OUGH PLUMB. YARD SPKLR SYSTEM MOB]LEHOME SVC. BAR SINK POR. gQ, FT. ® SEWER OR SEPTIC TANK ROUGH WIRING GAR. SO. FT. ® POWER OUTLET ROOF DRAINS FOUND. REINF. S (ROUGH) DRAINAGE PIPING CAR P. SO. FT. ® HEATING (FINAL) OTHER APPIEQUIP. WALL SO. FT. ® 000l 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 HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FRAMING w !Llx-llFINAL INSP. G GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNDRYTRAY AIR HANDLING UNIT CFM 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 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 GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEEPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR i1 4 SETBACK GROUND PLUMBIN UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE , ' Cr W; OUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. S (ROUGH) METER LOOP HEATING (FINAL) OTHER APPIEQUIP. REINF. STEEL 000l GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. $ plus x$ =$ LUMBER GR. FINAL INSP. :212ci G FRAMING w !Llx-llFINAL INSP. G ROOFING VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATIONISOUND3 FINISH GRADING FINAL INSPECTION/2-o � CERT. OCC. `(([ 111111 ccurc CIWAI REMARKS: SIGNATURESIINITIALS GARDEN WALL FINAL