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06666 (SFD)Building Address Address 74-923 8mv1e9 0130 T4ht " P.O. BOX 1504 78-105 CALLE ESTADO ..LA QUINTA, CALIFORNIA 92253 CityZip Tel. Palm Desert 92.264E 340-IP4, Contractor Address City lZip, State Lic. I City & Classif. 305699 Lic. # 1383 Arch., Engr., Designer Address Tel. City IZip I State Lic. # LICENSED CONTRACTOR'S DECLARATION I hereby.affirm,thit 1 am licensed under provisions of Chapter 9 (commencing with Section 70(10) of- Division 3 of the Business and Professions Code, and my license is in full force and effect �,✓'� ,... �� ' �i�"�� _ ; .r'' i � / f SIGNATURE DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sec.. 7031.5,8usiness and Professions Code: Any city or county which requires a permit to constrict, after, Improve, demolish, or repair any structure, prior to its issuance also requires the appdcant for such permit to Ide 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 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 civilpenalty of not more than rive hundred dollars (E500). 0 1, 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 safe. If, however, the building orimprovement is sold within one year of completion, the owner -builder will have the burden of proving that he did not bund or improve for the purpose of sale.) 0 1, 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.) 0 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 916opy 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 thg work for which this permit is issued, 1 shall not employ am 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 pemnft shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 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 100 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 No. 06666 BUILDING:..TYPE CONST. OCC: GRP. A.P.. Number. La Qd1X1>te $$ghAkl1dS fir 23269 Legal Description Project Description SFD Pian $ Lot 30 ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from.Property Line FINAL DATE INSPECTOR 11/17%89 Issued by: Date Permit Validated by: Validation: Sq. Ft. 1400 Size No. :Stories- • No. Dw. Units New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ Estimated Valuation $78,627 PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. $$�.( Const. 545..40 Mech. 60.00 Electrical 94.78 Plumbing 120.5 S.M.I. 5.23 Grading Driveway Enc. Infrastructure 1,759.1.1 TOTAL $3.053.12 REMARKS 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 11/17%89 Issued by: Date Permit Validated by: Validation: CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES 1ST FL. SO. FT. ® $ UNITS SLAB GRADE r ROUGH PLUMB. BONDING YARD SPKLR SYSTEM 2ND FL. SO. FT. FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR. SQ, FT. ® f*,%AS (ROUGH) Z R LOOP HEATING (FINAL) OTHER APPJEOUIP. POWER OUTLET ROOF DRAINS GAR. SQ. FT. ® GROUT WATER HEATER DRAINAGE PIPING CAR P. SQ. FT. ® BOND BEAM WALL SQ. FT. DRINKING FOUNTAIN =a LUMBER GR. URINAL SO FT ® FINAL INSP. &d ROOFING �� ESTIMATED CONSTRUCTION VALUATION $ ` WATER PIPING NOTE: Not to be used as property tax valuation FLOOR DRAIN MECHANICAL FEES VENTILATION WATER SOFTENER VENT SYSTEM FAN EVAP.000L HOOD SIGN WASHER(AUTO)(DISH) APPLIANCE DRYER FIREPLACE 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% c SEWAGE DISPOSAL SQ.FT.GAR ® V4c HOUSE SEWER CERT. OCC. 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 -.A " SETBACK GROUND PLUMBING e UNDERGROUND A.C. UNIT LOLL. AREA SLAB GRADE r ROUGH PLUMB. BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCT WORK ROCK STORAGE FOUND. REINF. �( Z f*,%AS (ROUGH) Z R LOOP HEATING (FINAL) OTHER APPJEOUIP. REINF. STEEL 7GAS (FINAL) TEMP. POLE GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM DING cu. yd. $ -Plus-X$ =a LUMBER GR. FINAL INSP. FRAMING .3 01� 90 FINAL INSP. &d ROOFING �� ' ©' ` REMARKS: VENTILATION FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR GAR. FIREWALL LATHING d t , MESH INSULATION/SOUND (1 FINISH GRADING FINAL INSPECTIONqd CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESIINITIALS GARDEN WALL FINAL