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001973 (ELEC)Building Address Owner Address City Contractor P.O. BOX 1504 No. 001973 78-105 CALLE ESTADO SAW Calla Milo LA QUINTA, CALIFORNIA 92253 L. lbmd BUILDING: TYPE CONST. OCC:. GRP. "400 Ca33.e Iloilo A.P. Number `7 Zip Tel. ,• -� J t 922".x3 „ 564-,5485 Legal Description Project Description "LiteDIsh Lista .lation 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 Ihereby 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. jam` Signature of applicant late Mailing Address f City, State, Zip HARD COPY ZONE: BY: az . ' );%l flag • . . City Zip Tel.- Rear Setback from Rear Prop. Line " Side Street Setback from Center Line Side Setback from Property Line FINAL DATE State Lic. City 1230- Date -8 Permit Validated by: & Classif. Lic. # Sq. Ft. No. No. Dw. A3669 12 30 6b 12. R Size Stories - Units •Arch.,•Engr:; Designer New 11C Add ❑ Alter ❑ Repair ❑ Demolition ❑ Address Tel. City Zip State - Lic. it _ . . 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'mylicense is in full force and *• -. effect. . _SIGNATURE DATE - �' • OWNER•BUILDER DECLARATION Estimated Valuation hereby affirm that I am exempt from the Contractor's License Law for the following reason: 7031..5,Business Code: Any • (Sec. and Professions city or county, which requires a - peimit'to construct, altei, 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 PERMIT AMOUNT ­ 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 exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by for Plan Chk. Dep. any applicant a permit ' subjects the applicant to a civil penalty of not more than five hundred dollars ($500).+ 0-1, the Plafi Chk. Bal. 21,12 as owner of 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; Bulsness and Const. y . Professions Code: The Contractor's License Law does not apply to an owner of property who 22.50 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 improvement is.sold within one year of completion, the owner -builder will have the burden Electrical "%�iri ofproving,that he. did not build or improve for the purpose of sale.) -- ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to con- Plumbing 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 S•M•1. • such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) - _ - Grading •. O I am exempt under Sec. B. 8 P.C. for this reason Driveway Enc. Date Owner : �� �= - - - '+� !' Infrastructure WORKERS' COMPENSATION DECLARATION 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. 31100, Labor Code.) PolicyNo. . Company O Copy is filed.wilh the city. ,O Certified.copy is hereby furnished. _ TOTAL 66.12 CERTIFICATE OF.EXEMPTION FROM REMARKS 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 Ihereby 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. jam` Signature of applicant late Mailing Address f City, State, Zip HARD COPY 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: 1230- Date -8 Permit Validated by: Validation: A3669 12 30 6b 12. R CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL.. SQ. FT. p $ 2ND FL. SQ. FT. POR. SQ. FT. ® GAR. SO. FT. ® CARP. SQ. FT. WALL SO. FT. ® SQ FT ® ESTIMATED CONSTRUCTION VALUATION $ UNITS MOBILEHOME SVC. POWER OUTLET YARD SPKLR SYSTEM BAR SINK ROOF DRAINS DRAINAGE PIPING DRINKING FOUNTAIN URINAL WATER PIPING NOTE: Not to be used as.property tax valuation BONDING FLOOR DRAIN MECHANICAL FEES FORMS WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASH ER(AUTO)(DISH) APPLIANCE DRYER GAS (ROUGH) GAR BAG E,DISPOSAL FURNACE UNIT WALL FLOOR. SUSPENDEDLAUNDRY OTHER APP./EOUIP. TRAY AIR HANDLING UNIT CFM TEMP. POLE 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. SQ. FT. ® c BATH TUB SO. FT. ® c WATER HEATER MAX. HEATER OUTPUT, B:T.U. SQ. FT. RESID ® 11/a c SEWAGE DISPOSAL SQ.FT.GAR ® 3/ac HOUSE SEWER REMARKS: 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 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./EOUIP. 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. FRAMING FINAL INSP. ROOFING REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING MESH INSULATION/SOUND FINISH GRADING FINAL INSPECTION CERT. OCC. FENCE FINAL 1 UM'S WUNA 1 UMtb11N1 I IALJ, GARDEN WALL FINAL c� eOt)Al.,'o CA &Z Z- aalpwn — L- /" Cil"Y OF LA SUBJEC79 0 ------------------ ANU %U CODES E : C 3 n 'ons p DATE DE _r. __r SZ A S A-7 - af buvo ; Z) 1-4-lW iE 7Me.