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04348 (SATT)"itovo� P.O. BOX 1504 Buildingo» 78-105 CALLE ESTADO Address Tangf�t vood ;LA QUINTA, CALIFORNIA 92253 Owner ~ -3=rise c'ompa"rly BUILDING: TYPE CONST. OCC. GRP. Mailing ;, Address 75-005 CE%L'dntry CU �� w .�,. � .� , A.P.-Number , . _ _ .. -PQ fit -The Green City Zips" Palm ear `9226 � � _ Legal Description Contractor... M - Vi AU Phase iG National Mortgage Project Description Ar1r1rACC Sam City Zip Tel. tate Classlc. f.CitLicy &# _ e... : , Sq. Ft.. _1498 , .... No. • No. Dw. Arch., Engr., Size Stories Units Designer New ❑ Add ❑ Alter ❑ Repair ❑ Demolition ❑ 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 the Business and Professions Code, and my license is in full force and effect. s; 1 r .t. �' :�,/ ri °` r,•r + / �. `< SIGNATURE+ DATE ,-,•,y, OWNER DECLARATION g rom t the Contractor's License Law for the following _ L'hereb affirm that I am exempt from " .:reason: '(Sec. 7031.5,Business and Professions Code: Any city or county which requires a ' permit, to, construct, alter, 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 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 penally of not more than five 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 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 contractor(s) licensed pursuant to the Contractor's License Law.) ❑ I am exempt under Sec. B. & P.C. for this reason Estimated Valuation 01144,179 PERMIT -- - AMOUNT. . Plan Chk. Dep. - - Plan Chk. BBI. yyy::5y A- . 1'.43 5 •yd 395,54- Const. 47.016.50 Mech. 139. 0, r7 iii V Electrical .70.46' Plumbing .87 .00 - S.M.I. &.02 Grading Driveway Enc.. NOTICE TO APPLICANT: If, • alter making this Certificate o/ Exemption you should become ` Date Owner Infrastructure ff !!� $2,r5169 «i�3 subject to the Workers' Compensation provisions of the Labor Code, you must forthwith X�i7 ed j J,, 284.52 comply with such provisions or this permit shall be deemed revoked. WORKERS' COMPENSATION DECLARATION '�ri..a �`' •R, �Gti a UIeE 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.) Front Setback from Center Line - Policy No. Company Rear Setback from Rear Prop. Line CONSTRUCTION LENDING AGENCY Copy is filed with the city. O Certified copy is hereby furnished. t< Side Street Setback from Center Line ; � a ^� - I hereby affirm that there is a construction lending agency for the performance of the.. TOTAL s7 t. ��t n ', - t ; 14 CERTIFICATE OF EXEMPTION FROM REMARKS ' WORKERS' COMPENSATION INSURANCE i �. (This section need not be completed I/ the permit is for one hundred dollars (8100) valuafbn ,� ,•,��,;}"1"�7n4;+4 xf 07-21•*sig,•.;•__ ._ f+ K , 10- or less.) - t I certify that in the performance of thg work for which this permit is issued, I shall not •• �--. r.r a.� :: F r_�' I yYY» it - {6.y7�'5.,1 a w�'1: employ any person in any manner so as to become subject to the Workers' Compensation Laws of California.' Date - owner NOTICE TO APPLICANT: If, • alter making this Certificate o/ Exemption you should become ZONE: BY: - subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Distances: - comply with such provisions or this permit shall be deemed revoked. Minimum Setback - Front Setback from Center Line - 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.. t . work for which this permit is issued. (Sec. 309 7,Civil Code.) Side Setbackfrom Property Line - Lender's Name - Lender's. Address' r This is -a buildingpermit when properly filled out, signed and validated, and is subject to •. P P P Y 1 FINAL DATE 7I SRECTOO, R fSi 7 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. 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- bove -mentioned •mentioned property for inspection purposes. Validated by: Signature of applicant Date 1 't•+ Mailing Address - Validation. City, State, Zip - l - l v WHITE FINANCE PINK APPLICANT, GREEN BUILDING GOLDENROD _�..Vr'x;�rS Y.. .�. •.., .',�..( �-: �,'..: .. .- -,:w ..�,�!-.•:i.! v.. .. r... .... r.. a.. ,nl �t-.. -_.- - ASSESSORS OFFICE, HARD COPY -FILES �-'t:'T. ^1.r:,.:i- ra.. .. e.. .J�'^a'R.i .�- .::'1 +... ~ ^ _ - :y+. CONSTRUCTION ESTIMATE NO. ELECTRICAL FEES NO. _PLUMBING FEES IST FL SO FT y $ UNITS SLAB GRADE ROUGH PLUMB BONDING Y ARD SPKLR SYSTEM 2ND FL SO FT, e;R FORMS SEWER OR SEPTIC TANK ROUGH WIRING MOBILEHOME SVC. BAR SINK POR SO FT. Qr GAS (ROUGH) METER LOOP HEATING (FINAL) POWER OUTLET ROOF DRAINS GAR SO. FT. TEMP. POLE GROUT DRAINAGE PIPING CAR P. SO FT. f6' FINAL INSP. BOND BEAM WATER SYSTEM DRINKING FOUNTAIN WALL SO. FT. (a - $ LUMBER GR. FINAL INSP. URINAL SO. FT. (a 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 WASH ER(AUTO)(DISH) APPLIANCE DRYER FIREPLACE GARBAGE DISPOSAL FURNACE UNIT WALL FLOOR SUSPENDED LAUNORYTRAY 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 (a' 1 V: c SEWAGE DISPOSAL SO.FT.GAR Vic 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 PLUMBIN:, ELECTRICAL HEATING 8 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.IEOUIP. REINF. STEEL GAS (FINAL) TEMP. POLE GROUT WATER HEATEF 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 INSULATIONISOUND FINISH GRADING TION kl 16& CERT. OCC. FENCE FINAL INSPECTOR'S SIGNATURES/INITIALS _ GARDEN WALL FINAL :d