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001545 (AR)T4tyl 4 4 4" P.O. BOX 1504 BuildingO 78--310 Crestview �� LA QUINTACCALIFORNIADO ddress 92253 City Zip 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 fhe Business and Professions Code, and my license is in full force and effect. '` �.lJ t.dryr . ` �t !, .•� rf t7 ,'_, �'"``^ SIGNATURE - DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's. License law for the following reason: (Sec. 7031.5,Business 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 applicant for such permit to file 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 Business and Professions Code, or thathe is exempi 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 live 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 builds 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 or improvement is sold within one year of completion, the, owner -builder will have the burden o! proving that he did not build or improve for the purpose ol.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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt -under Sec. - B. & P.C. for this reason Date Owner I WORKERS' COMPENSATION DECLARATION 1 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.) I certify that in the performance of thg 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: If, after making this Certificate of 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 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 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 sof this city to enter the above- mentioned property for inspection purposes. l .r^ Signature of applicant` �f ; f r �% t T'� Date ` Mailing Address City, State, Zip HARD COPY No. 001545 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 617-062-401 - Tg* 33 Legal Description Project Description Sq. q eFt. �" 713 No. No. Dw. Stories Units New ❑ Add X Alter ❑ ' RepairV Demolition ❑ ;timated Valuation 53.x000.00 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. ' Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL 612.0 REMARKS AMOUNT 00.00 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 Permit Validated by: Validation: A 1 4 6 0 6. 6 51Z00 -a- W.T. Carruft� Mailing Address 78..3j-1 i C�:`C'�`�i7Y£ City Zip Tel. La Qrt� 9=3 Contractor Address. 332 WiUiam City " Zip Tel. Palm Sprue cAi 320-9900 State Lic. City & Classif. 376244 Lic. # Arch:, Engr., Designer Address 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) of Division 3 of fhe Business and Professions Code, and my license is in full force and effect. '` �.lJ t.dryr . ` �t !, .•� rf t7 ,'_, �'"``^ SIGNATURE - DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's. License law for the following reason: (Sec. 7031.5,Business 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 applicant for such permit to file 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 Business and Professions Code, or thathe is exempi 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 live 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 builds 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 or improvement is sold within one year of completion, the, owner -builder will have the burden o! proving that he did not build or improve for the purpose ol.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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ 1 am exempt -under Sec. - B. & P.C. for this reason Date Owner I WORKERS' COMPENSATION DECLARATION 1 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.) I certify that in the performance of thg 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: If, after making this Certificate of 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 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 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 sof this city to enter the above- mentioned property for inspection purposes. l .r^ Signature of applicant` �f ; f r �% t T'� Date ` Mailing Address City, State, Zip HARD COPY No. 001545 BUILDING: TYPE CONST. OCC: GRP. A.P. Number 617-062-401 - Tg* 33 Legal Description Project Description Sq. q eFt. �" 713 No. No. Dw. Stories Units New ❑ Add X Alter ❑ ' RepairV Demolition ❑ ;timated Valuation 53.x000.00 PERMIT Plan Chk. Dep. Plan Chk. Bal. Const. Mech. ' Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL 612.0 REMARKS AMOUNT 00.00 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 Permit Validated by: Validation: A 1 4 6 0 6. 6 51Z00 -a- CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST FL, SQ. FT. ® $ UNITS SLAB GRADE ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SQ. FT. FORMS SEWER OR SEPTIC TANK POR. SO. FT. ® MOBILEHOME SVC. BAR SINK GAR. SQ. FT. ® POWER OUTLET ROOF DRAINS HEATING (FINAL) OTHER APP.IEQUIP. DRAINAGE PIPING CAR P, SQ. FT. ® TEMP. POLE WALL SQ. FT. GROUT DRINKING FOUNTAIN SQ FT ® FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE; Not to be used as property tax valuation $ FLOOR DRAIN MECHANICAL FEES yf_FINAL INSP. 2, WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER 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, TEMIPERM LAVATORY HEATING SYSTEM FORCED GRAVITY AMPERES SERV ENT SHOWER BOILER B.T.U. SQ. FT. ® c BATH TUB GAR. FIREWALL SQ. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SQ. FT. RESID @ 11/4 c SEWAGE DISPOSAL SO.FT.GAR ® 3/ac HOUSE SEWER T1 i INSULATIONISOUND GAS PIPING PERMIT FEE FINISH GRADING PERMIT FEE PERMIT FEE DBL TOTAL FEES MICRO FEE MECH.FEE IPL.CK.FEE CONST. FEE ELECT. FEE SMI FEE PLUMB. FEE STRUCTURE PLUMBING ELECTRICAL HEATING & AIR COND. SOLAR SETBACK GROUND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA SLAB GRADE ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. GAS (ROUGH) METER LOOP HEATING (FINAL) OTHER APP.IEQUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING yd. $ plus x$_= $ LUMBER GR. yf_FINAL INSP. 2, FRAMING eLeFINAL INSP. n ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH T1 i INSULATIONISOUND FINISH GRADING P(INAL INSPECTION 5 CERT, OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS, GARDEN WALL FINAL 0 F_'( 111 11, 6 5 hl.E w 2 X L WA Z Z.s 1rzc- O -L Add_ onl _ N AL�.s. {2cM 4. x� 1\107 .5 71N? axe! vU� LLS Id w )IL RDD -DNS EWWALLS Ak . 7vtca j � .PooiiNa NC �N ADD-�1 w - _-3 10 C60E — V) g ut -: RRAc c _1.._ ,_ :. APPROVED -PLAN 2XL WA J. s WAL4s ROM �12Ls oti- � oA/ ' 17 r ti Fr> ° � _�-��.;;;: �:r,� ' ��, . (. � •.x.1,.3, _ yy :w:..,.-_.:�. �" w;� z:. `�_ , "; � �.,.._�.w�.'��`���.�:- ��••`s 3s�t;-:-•� � . •,•, _ . �/ G ♦ /.�) jq LZ S %� 07 AA�AG&�. ..- ! , -a ~ i�ca s>7 'i•^2 :4w i - T -':tK k,{i5 ' i'S '=.�"..a • 1 _ 4 `t M ..c-.+.'.."'�'� y�, /s J / �• _' �� - _ t - �� a -� _ : {.'1 +T'-"x� .'r - { . - .:N.. - y .'us . sy,.}?:•' _ra- ,e.Y.�.T'wr 'S;£� T _ k~ _ . y'�. - - - d.L�✓'.Lr-.-' 1. rt` �,�. u. .,....=, Y. 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