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04897 (SFD)�` =:� •fir•. , . , .: , -, �, a. P.O. BOX 1504 ' r Building'' o. , , 78=105 CALLE ESTADO :-Address.-" �' �'6g' erenatem CoUrt LA OUINTA, CALIFORNIA 92253 ->x,.s�:•.- �' Bar Clift Dayttlopment BUILDING: TYPE CONST. ing�OCC. GRP. iMail' „ • `,'Address,,. - ?are TSA Q�i1Df Pl fi -7 .1 pia -ran ROA -4 #I A.P. Number city, Zip fel. .4 0B C4i,d-rni -ClOr 92234 �7.3,�9 324; Legal Description Contractor r _ Plan 2222, Phase x Project Description Same, � Lot 1 Address-" City +s Zip State -ssif. Arch.,•,Engr', Designer Address t �. - Tel. City Lic. # - Tel. City,, :n;Zip State Lic. # r LICENSEO=NTRACTOR'S DECLARATION I hereby affirm. that I am licensetl under provisions of Chapter 9 (commencing with Section 7000) t. of Division 3:6f,the Business•and Professions Code, and my license,Fis in full force and 'effec 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,Iafter, timprove, 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, -43 olathe Business and Professions Code, or that. he is exempt therefrom, and the basis ' for the efteged-.-exemption.' Any violation of Section 7031.5 by any applicant for a permit subjects,.the•applicantto•a,&vApenalty of not more than five hundred dollars ($500). a ❑ 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, prodded that such Improvements, are not intended or offered for sale. If, however, the building or'improverrient'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 sale.) " O• I, a§ owner of the property, am exclusively contracting with licensed contractors to con, r, 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 pursuant to the, Contractor's License Law.) ~ ❑'1 am•exempt under Sec.~ e B. & P.C. for this reason Date f Owner ' { X WORKERS' COMPENSATION DECLARATION 1 •hereby affirm that I have a certificate of consent to self -insure, or a certificate of i Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No: Company s O Copy is filed with the city. ❑ Certified copy is hereby furnished. :t CERTIFICATE OF EXEMPTION FROM `z `,^ WORKERS' COMPENSATION INSURANCE '•(This section need not be completed if the pemHt is for one hundred dollars ($100) vatuation or less.) p, 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, TOTAL 7,0 rt..�(:%�%'zr,ij• REMARKS • T,471�i .�Mi'_+Fixltif� ��-ii•YF OR <}'X^��h��R�. FJa C�It ?� NOTICE,TO APPLICANT: If„after making this Certificate of Exemption you should become ZONE: BY: ' subject to. the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. (-Sq. Ft. Size 2222 No. • No. Dw. 1 Stories 2 Units - New ❑ Add ❑ Alter ❑ Repair ❑ '' Demolition ❑ ` • r Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line I hereby affirm that there is a construction lending agency for the performance of the r . Estimated Valuation $112 t61 PERMIT AMOUNT Plan Chk. Dep. • _ t Plan Chk. Bal.-: 387,64 Const. 465.50 Mech. 53.00 Electrical 85.19 Plumbing 98.00 S.M.I. 7. A-8 Grading Driveway Enc. Infrastructure 2,523.63. Validated by: : 'Signature of applicant Date Mailing Address TOTAL 7,0 rt..�(:%�%'zr,ij• REMARKS • T,471�i .�Mi'_+Fixltif� ��-ii•YF OR <}'X^��h��R�. FJa C�It ?� NOTICE,TO APPLICANT: If„after making this Certificate of Exemption you should become ZONE: BY: ' subject to. the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Minimum Setback Distances: Front Setback from Center,Lin � ` Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Side Street Setback from Center Line 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.) Side Setback from Property.Line- Lender's Name - Lender's Address FINAL DATE INSPECTOR This',is s building permit when properly filled out, signed and validated, and is subject to expiration if work thereunder is suspended for 180 days. - -.�� / 6 % $, r 1 •I certify that I have read this application and state that the above information Is correct. Issued by: Date / Permit 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- to mentioned property for inspection purposes. Validated by: : 'Signature of applicant Date Mailing Address Validation: r - City,' State, Zip ,�(}•`� �a::3: * _ 'WHITE -FINANCE, PINK - APPLICANT, GREEN - BUILDING, GOLDENROD - ASSESSOR'S OFFICE, HARD COPY - FILES,__ ; •• Z -5{)'i - �:l Sir .t. � i -n-.•• '.•-._ '. _ ..<. .. .... ..w ,.- f.. ..a.-. .. .. ,..- .A -.... -.. •.... �.]_ _. i. --• -- .-. .. _ CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. PLUMBING FEES IST Fi-. SO FT y S UNITS LAS GRADE, 'ZL 2ND FL SO FT. YARD SPKLR SYSTEM STORAGE TANK MOBILEHOME SVC. BAR SINK POR SO FT. a DUCTWORK ROCK STORAGE GAR SO. FT. C1 POWER OUTLET ROOF DRAINS HEATING (FINAL) - OTHER APP.IEOUIP. DRAINAGE PIPING CAR P. SO FT. (& WALL SO. FT. (a GROUT DRINKING FOUNTAIN SO FT (a FINAL INSP. URINAL ESTIMATED CONSTRUCTION VALUATION $ WATER SYSTEM WATER PIPING NOTE: Not to be used as property tax valuation =S FLOOR DRAIN MECHANICAL FEES FRAMING ( WATER SOFTENER VENT SYSTEM FAN EVAP.COOL HOOD SIGN WASHER(AUTONDISH) 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. SO. FT. ®c BATH TUB SO. FT. @ c WATER HEATER MAX. HEATER OUTPUT, B.T.U. SO. FT. RESID @ 1 V. c SEWAGE DISPOSAL SO.FT.GAR (g 3/4c . HOUSE SEWER FINISH GRADING. 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 8 AIR COND. SOLAR SETBACK , ND PLUMBING UNDERGROUND A.C. UNIT COLL. AREA LAS GRADE, 'ZL ROUGH PLUMB BONDING HEATING (ROUGH) STORAGE TANK FORMS SEWER OR SEPTIC TANK ROUGH WIRING DUCTWORK ROCK STORAGE OUND. REINF. `'7 / �G GAS (ROUGH) 7 METER LOOP HEATING (FINAL) - OTHER APP.IEOUIP. REINF. STEEL GAS (FINAL) P. POLE v GROUT WATER HEATER SERVICE FINAL INSP. BOND BEAM WATER SYSTEM GRADING cu. yd. -plus-x$ =S LUMBER GR. FINAL INSP. 6 -ZA�Q�,7 FRAMING ( FINAL INSP. ROOFING N lO VENTILATION ' 7Q/�� REMARKS: FIRE ZONE ROOFING FIREPLACE SPARK ARRESTOR - GAR. FIREWALLof LATHING > 7 MESH INSULATION/SOUND FINISH GRADING. FINAL INSPECTION CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURESINITIALS GARDEN WALL FINAL