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05112 (MFD5)Building Address Owner Mailing Address City [ax'a?1 Contractor Address T4hf 4 4 QA ba I 78-159 Crimson Drive City lZip P.O. BOX 1504 N o . WMAL Z 78-105 CALLE ESTADO LA QUINTA, CALIFORNIA 92253 BUILDING: TYPE CONST. OCC: GRP. lair. A.P. Number ( X13—t9i�--t)t74 vR Legal Description Project Description T2L.4 -44.�Z1 II f State Lic. City & Classif. P311261 Lic. # 1177 Arch., Engr., Designer Address CityI Zip I State Lic. # LICENSED CONTRACTOR'S DECLARATION 1 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 affirlm that I am exempt from the Contractor's License Law for the following reason: (Sec. 7031.5,8usihess and Professions Code: Any city or county which requires a permit to eruct, after, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to rile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the 131siless 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 not 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 Contractor's License Law does not apply to an owner of property who briA2s 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. If, however, the building orimprovement is sold within one year of completion, the owner -builder wig 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 with a comtractor(s) 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 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 furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) 1 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., lf, after making this Certificate or Exemption you should become subject 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 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 Lender's 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 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 Sq. Ft. 926 Size I No. No. Dw. Stories Units " New ❑ Add ❑ Alter ❑ Repair ❑ -Demolition ❑ I Estimated Valuation 566731 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. 777 82 Const. 1A . Q) Mech. ., Electrical A Plumbing 75,00 S.M.I. A AA Grading Driveway Enc. Infrastructure 1 , 501. 45 V. a,e► - Tin 4. A R_ IS TOTAL A a 15 e "a t e:7 REMARKS 4. 1, ` �1y4r} is l'i j X Xi J 1711.K. L.Ta 1 `iJ.f.La..C) f.l \ 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 12 8/881 Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL SQ. FT. ® $ UNITS SLAB GRADE ( I� qG� ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL SQ. FT. @ FORMS SEWER OR SEPTIC TANK ROUGH WIRING. MOBILEHOME SVC. BAR SINK POR. SQ. FT. ® GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR. SO. FT. ® GROUT DRAINAGE PIPING CAR P. I SQ. FT. FINAL INSP. WALL SQ. FT. WATER SYSTEM DRINKING FOUNTAIN. GRADING cu. yd. -Plus-X$-=$ URINAL SQ. FT. ® FRAMING Q, FINAL INSP. ESTIMATED CONSTRUCTION VALUATION $ ✓li /G�Dd� ���w/� _ �--) / /461FINAL �,(/0�y 3 r WATER PIPING NOTE Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES WATER SOFTENER VENT SYSTEM FAN EVAP.000L 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. SQ. FT. ® c BATH TUB SQ. FT. ® c WATER HEATER MAX HEATER OUTPUT, B.T.U. SQ. FT. RESID ® 1+/4 c SEWAGE DISPOSAL INSPECTI SQ.FT.GAR ® V4c HOUSE SEWER CERT. OCC. GAS PIPING PERMIT FEE PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FIPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING// z.4 ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ( I� qG� ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING. DUCT WORK ROCK STORAGE FOUND. REINF. 1/G) vv,, GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APPJEOUIP. REIN F. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM $ GRADING cu. yd. -Plus-X$-=$ LUMBER GR. FINAL INSP. FRAMING Q, FINAL INSP. ROOFING ✓li /G�Dd� ���w/� _ �--) / /461FINAL �,(/0�y 3 r REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR 'GAR. FIREWALL LATHIZG MESH INSULATIONISOUNell FINISH GRADING INSPECTI CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS ' GARDEN WALL FINAL cityp.f .. int 'LaQua 78495 CALLE TAMPICO LA QUINTA, CALIFORNIA (760) 777-7012 [FAX] (760) 777-7011 INSPECTION RECORD Permit # 9808-002 STRUCTURAL RETROFIT OF UNIT ADDRESS DATE INSPECTION' [YES/NO] 7 `8 FRAMING/HARDWARE PLAN TYPE: AX--, j INSULATION Contractor: WERMERS MULTI -FAMILY CORP. SHEAR NAILING DRYWALL JOB FINAL COMMENTS/NOTES: h1 In7cePie-8 13y 9, P. g)A L,4- IJ MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALLIFORNIA 92253